Engineered bacteriophages as adjuvants for antimicrobial agents and compositions and methods of use thereof

ABSTRACT

The present invention relates to the treatment and prevention of bacteria and bacterial infections. In particular, the present invention relates to engineered bacteriophages used in combination with antimicrobial agents to potentiate the antimicrobial effect and bacterial killing by the antimicrobial agent. The present invention generally relates to methods and compositions comprising engineered bacteriophages and antimicrobial agents for the treatment of bacteria, and more particularly to bacteriophages comprising agents that inhibit antibiotic resistance genes and/or cell survival genes, and/or bacteriophages comprising repressors of SOS response genes or inhibitors of antimicrobial defense genes and/or expressing an agent which increases the sensitivity of bacteria to an antimicrobial agent in combination with at least one antimicrobial agent, and their use thereof.

CROSS REFERENCE TO RELATED APPLICATIONS

This application claims priority under 35 U.S.C. 119(e) of U.S. Provisional Patent Application Ser. No. 61/020,197 filed 10 Jan. 2008, the contents of which are incorporated herein by reference in their entirety.

GOVERNMENT SUPPORT

This invention was made with the Government support under Contract No. EF-0425719 awarded by the National Science Foundation (NSF) and Contract No. OD003644 awarded by the National Institutes of Health (NIH). The Government has certain rights in the invention.

FIELD OF THE INVENTION

The present invention relates to the field of treatment and prevention of bacteria and bacterial infections. In particular, the present invention relates to engineered bacteriophages used in combination with antimicrobial agents to potentiate the antimicrobial effect and bacterial killing of the antimicrobial agent.

BACKGROUND

Bacteria rapidly develop resistance to antibiotic drugs within years of first clinical use¹. Antibiotic resistance can be acquired by horizontal gene transfer or result from persistence, in which a small fraction of cells in a population exhibits a non-inherited tolerance to antimicrobials². Since antimicrobial drug discovery is increasingly lagging behind the evolution of antibiotic resistance, there is a pressing need for new antibacterial therapies³.

Bacterial infections are responsible for significant morbidity and mortality in clinical settings³. Though the advent of antibiotics has reduced the impact of bacterial diseases on human health, the constant evolution of antibiotic resistance poses a serious challenge to the usefulness of today's antibiotic drugs³⁻⁷. Infections that would have been easily cured by antibiotics in the past are now able to survive to a greater extent, resulting in sicker patients and longer hospitalizations^(5,8,9). The economic impact of antibiotic-resistant infections is estimated to be between US $5 billion and US $24 billion per year in the United States alone¹⁰. Resistance to antibiotic drugs develops and spreads rapidly, often within a few years of first clinical use¹. However, the drug pipelines of pharmaceutical companies have not kept pace with the evolution of antibiotic resistance^(1,3).

Acquired antibiotic resistance results from mutations in antibacterial targets or from genes encoding conjugative proteins that pump antibiotics out of cells or inactivate antibiotics¹¹. Horizontal gene transfer, which can occur via transformation, conjugative plasmids, or conjugative transposons, is a major mechanism for the spread of antibiotic resistance genes^(12,13). For example, Staphylococcus aureus became quickly resistant to sulpha drugs in the 1940s, penicillin in the 1950s, and methicillin in the 1980s¹². In 2002, staphylococci developed resistance to vancomycin, the only uniformly effective antibiotic against staphylococci, by receiving vancomycin-resistance genes via conjugation from co-infecting Enterococcus faecalis, which itself became completely resistant to vancomycin in nosocomial settings by 1988^(12,14). Drugs such as ciprofloxacin that induce the SOS response can even promote the horizontal dissemination of antibiotic resistance genes by mobilizing genetic elements^(15,16). For example, Streptococcus pneumoniae and Neisseria gonorrhoeae have also obtained resistance to antibiotics (Morens, et al., (2004) Nature 430: 242-249). Sub-inhibitory concentrations or incomplete treatment courses can present evolutionary pressures for the development of antibiotic resistance¹⁷. Use of antibiotics outside of clinical settings, for example in livestock for the agricultural industry, has contributed to the emergence of resistant organisms such as methicillin-resistant staphylococci and is unlikely to abate due to economic reasons and modern farming practices^(12,18). Resistance genes that develop in non-clinical settings may be subsequently transmitted to bacterial populations which infect humans, worsening the antibiotic resistance problem¹².

In addition to acquiring antibiotic-resistance genes, a small subpopulation of cells known as persisters can survive antibiotic treatment by entering a metabolically-dormant state^(2,19,20). Persister cells do not typically carry genetic mutations but rather exhibit phenotypic resistance to antibiotics²¹. In Escherichia coli, the fraction of a population which represents persister cells increases dramatically in late-exponential and stationary phases. Chromosomally-encoded toxins may be important contributors to the persister phenotype but the underlying mechanisms that control the stochastic persistence phenomena are not well understood²²⁻²⁵. Persisters constitute a reservoir of latent cells that can begin to regrow once antibiotic treatment ceases and may be responsible for the increased antibiotic tolerance observed in bacterial biofilms²⁰. By surviving treatment, persisters may play an important role in the development of mutations or acquisition of genes that confer antibiotic resistance.

Several strategies have been proposed for controlling antibiotic resistant infections. New classes of antibiotics would improve the arsenal of drugs available to fight antibiotic-resistant bacteria but few are in pharmaceutical pipelines^(3,26). Surveillance and containment measures have been instituted in government and hospitals so that problematic infections are rapidly detected and isolated but do not address the fundamental evolution of resistance¹². Cycling antibiotics is one method of controlling resistant organisms but is costly and may not be efficacious^(27,28). Reducing the overprescribing of antibiotics has only moderately reduced antibiotic resistance²⁹. Efforts have been also made to lessen the use of antibiotics in farming but some use is inevitable³⁰. Using bacteriophage to kill bacteria has been in practice since the early 20^(th) century, particularly in Eastern Europe^(16,17). Bacteriophage can be chosen to lyse and kill bacteria or can be modified to express lethal genes to cause cell death³¹⁻³⁵. However, bacteriophage which are directly lethal to their bacterial hosts can also produce phage-resistant bacteria in short amounts of time^(6,7,31,32,36). In addition to the aforementioned approaches, novel methods for designing antimicrobial drugs are becoming more important to extending the lifespan of the antibiotic era³⁷. Combination therapy with different antibiotics or antibiotics with phage may enhance bacterial cell killing and thus reduce the incidence of antibiotic resistance, and reduce persisters³⁸⁻⁴¹. Unmodified filamentous bacteriophage have been shown to augment antibiotic efficacy⁴². Systems biology analysis can be employed to identify pathways to target and followed by synthetic biology to devise methods to attack those pathways^(38,43,44).

Bacterial biofilms are sources of contamination that are difficult to eliminate in a variety of industrial, environmental and clinical settings. Biofilms are polymer structures secreted by bacteria to protect bacteria from various environmental attacks, and thus result also in protection of the bacteria from disinfectants and antibiotics. Biofilms can be found on any environmental surface where sufficient moisture and nutrients are present. Bacterial biofilms are associated with many human and animal health and environmental problems. For instance, bacteria form biofilms on implanted medical devices, e.g., catheters, heart valves, joint replacements, and damaged tissue, such as the lungs of cystic fibrosis patients. Bacteria in biofilms are highly resistant to antibiotics and host defenses and consequently are persistent sources of infection.

Biofilms also contaminate surfaces such as water pipes and the like, and render also other industrial surfaces hard to disinfect. For example, catheters, in particular central venous catheters (CVCs), are one of the most frequently used tools for the treatment of patients with chronic or critical illnesses and are inserted in more than 20 million hospital patients in the USA each year. Their use is often severely compromised as a result of bacterial biofilm infection which is associated with significant mortality and increased costs. Catheters are associated with infection by many biofilm forming organisms such as Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis and Candida albicans which frequently result in generalized blood stream infection. Approximately 250,000 cases of CVC-associated bloodstream infections occur in the US each year with an associated mortality of 12%-25% and an estimated cost of treatment per episode of approximately $25,000. Treatment of CVC-associated infections with conventional antimicrobial agents alone is frequently unsuccessful due to the extremely high tolerance of biofilms to these agents. Once CVCs become infected the most effective treatment still involves removal of the catheter, where possible, and the treatment of any surrounding tissue or systemic infection using antimicrobial agents. This is a costly and risky procedure and re-infection can quickly occur upon replacement of the catheter.

Bacteriophages (often known simply as “phages”) are viruses that grow within bacteria. The name translates as “eaters of bacteria” and reflects the fact that as they grow, the majority of bacteriophages kill the bacterial host in order to release the next generation of bacteriophages. Naturally occurring bacteriophages are incapable of infecting anything other than specific strains of the target bacteria, undermining their potential for use as control agents.

Bacteriophages and their therapeutic uses have been the subject of much interest since they were first recognized early in the 20th century. Lytic bacteriophages are viruses that infect bacteria exclusively, replicate, disrupt bacterial metabolism and destroy the cell upon release of phage progeny in a process known as lysis. These bacteriophages have very effective antibacterial activity and in theory have several advantages over antibiotics. Most notably they replicate at the site of infection and are therefore available in abundance where they are most required; no serious or irreversible side effects of phage therapy have yet been described and selecting alternative phages against resistant bacteria is a relatively rapid process that can be carried out in days or weeks.

Bacteriophage have been used in the past for treatment of plant diseases, such as fireblight as described in U.S. Pat. No. 4,678,750. Also, Bacteriophages have been used to destroy biofilms (e.g., U.S. Pat. No. 6,699,701). In addition, systems using natural bacteriophages that encode biofilm destroying enzymes in general have been described. Art also provides a number of examples of lytic enzymes encoded by bacteriophages that have been used as enzyme dispersion to destroy bacteria (U.S. Pat. No. 6,335,012 and U.S. Patent Application Publication No. 2005/0004030). The Eastern European research and clinical trials, particularly in treating human diseases, such as intestinal infections, has apparently concentrated on use of naturally occurring phages and their combined uses (Lorch, A. (1999), “Bacteriophages: An alternative to antibiotics?” Biotechnology and Development Monitor, No. 39, p. 14-17).

For example, non-engineered bacteriophages have been used as carriers to deliver antibiotics (such as chloroamphenicol) (Yacoby et al., Antimicrobial agents and chemotherapy, 2006; 50; 2087-2097). Non-engineered bacteriophages have also had aminoglycosides antibiotics, such as chloroamphenicol, attached to the outside of filamentous non-engineered bacteriophage (Yacoby et al., Antimicrobial agents and chemotherapy, 2007; 51; 2156-2163). M13 non-lytic bacteriophages have also been engineered to carry lethal cell death genes Gef and ChpBK. However, these phages have not been used, or suggested to be useful in combination with antimicrobial or antibiotic agents (Westwater et al., 2003, Antimicrobial agents and chemotherapy, 47; 1301-1307). Non-engineered filamentous Pf3 bacteriophages have also been administered with low concentration of gentamicin, where neither the filamentous Pf3 or the gentamicin could eliminate the bacterial infection alone (Hagens et al, Microb. Drug resistance, 2006; 12; 164-8). The non-engineered bacteriophage and the antibiotic enrofloxacin have been administered simultaneously, although the use of the antibiotic was more effective than the combination of the antibiotic and bacteriophage (see Table 1 in Huff et al., 2004; Poltry Sci, 83; 1994-1947).

Constant evolutionary pressure will ensure that antibiotic resistance bacteria will continue to grow in number. The dearth of new antibacterial agents being developed in the last 25-30 years certainly bodes poorly for the future of the antibiotic era (Wise, R (2004) J Antimicrob Chemother 54: 306-310). Thus, new methods for combating bacterial infections are needed in order to prolong the antibiotic age. For example, bacteriophage therapy or synthetic antibacterial peptides have been proposed as potential solutions (Loose et al., (2006) Nature 443: 867-869; Curtin, et al., (2006) Antimicrob Agents Chemother 50: 1268-1275).

Because antibiotic resistance in treating bacterial infections and biofilms poses a significant hurdle to eliminating or controlling or inhibiting bacteria and biofilms with conventional antimicrobial drugs, new anti-biofilm strategies, such as phage therapy, should be explored. Novel synthetic biology technologies are needed to enable the engineering of natural phage with biofilm-degrading enzymes to produce libraries of enzymatically-active phage, which can complement efforts to screen for new biofilm-degrading bacteriophages in the environment.

SUMMARY

The inventors have discovered a two pronged strategy to significantly reduce or eliminate a bacterial infection. In particular, the inventors have engineered bacteriophages to be used in combination with an antimicrobial agent, such that the engineered bacteriophage functions as an adjuvant to the antimicrobial agent. In particular, the inventors have engineered bacteriophages to specifically disable (or deactivate) the bacteria's natural resistance mechanisms to the antimicrobial agents and/or phage infection. Accordingly, one aspect of the present invention generally relates to engineered bacteriophages which have been modified or engineered to (i) inhibit at least one bacterial resistance gene, or (ii) to inhibit at least one SOS response gene or bacterial defense gene in bacteria, or (iii) to express a protein which increases the susceptibility of a bacterial cell to an antimicrobial agent. Any one of these engineered bacteriophages, used alone, or in any combination can be used with an antimicrobial agent. Accordingly, the inventors have discovered a method to prevent the development of bacterial resistance to antimicrobial agents and the generation of persistent bacteria by inhibiting the local bacterial synthetic machinery which normally circumvents the antimicrobial effect, by engineering bacteriophages to be used in conjunction (or in combination with) an antimicrobial agent, where an engineered bacteriophage can inhibit an antimicrobial resistance gene, or inhibit a SOS response gene or a non-SOS bacterial defense gene, or express a protein to increase the susceptibility of a bacterial cell to an antimicrobial agent.

Accordingly, one aspect of the present invention relates to the engineered bacteriophages as discussed herein for use in conjunction with (i.e. in combination with) at least one antimicrobial agent, and that the engineered bacteriophages serve as adjuvants to such antimicrobial agents. Another aspect of the present invention relates to a method for inhibiting bacteria and/or removing bacterial biofilms in environmental, industrial, and clinical settings by administering a composition comprising at least one engineered bacteriophages as discussed herein with at least one antimicrobial agent.

One aspect of the present invention relates to methods of using engineered bacteriophages in combination with antimicrobial agents to potentiate the antimicrobial effect of bacterial killing (i.e. eliminating or inhibiting the growth or controlling the bacteria) by the antimicrobial agent. Accordingly, the present invention relates to the discovery of an engineered bacteriophage as an antibiotic adjuvant. In some embodiments, an engineered bacteriophage as discussed herein functions as an antibiotic adjuvant for an aminglycoside antimicrobial agent, such as but not limited to, gentamicin, as an antibiotic adjuvant for β-lactam antibiotics, such as but not limited to, ampicillin, and as antibiotic adjuvants for quinolones antimicrobial agents, such as but not limited to, ofloxacin.

Another aspect of the present invention relates to an engineered bacteriophage which comprises a nucleic acid encoding an agent which inhibits at least one gene involved in antibiotic resistance. In such and embodiment of this aspect of the invention, an engineered bacteriophage can comprise at least 2, 3, 4, 5 or even more, for example 10 different nucleic acids which inhibit at least one gene involved in antibiotic resistance. In an alternative embodiment, an engineered bacteriophage can comprise a nucleic acid encoding an agent which inhibits at least one gene involved in cell survival repair. In another embodiment, an engineered bacteriophage can comprise at least 2, 3, 4, 5 or even more, for example 10 different nucleic acids which inhibit at least one gene involved in cell survival repair. Such engineered bacteriophages as disclosed herein which comprise a nucleic acid encoding an agent which inhibits at least one gene involved in bacterial antibiotic resistance and/or cell survival gene are referred to herein as “inhibitor-engineered bacteriophages”. In some embodiments, the agent inhibits the gene expression and/or protein function of antibiotic resistance genes such as, but not limited to cat, vanA or mecD. In some embodiments, the agent inhibits the gene expression and/or protein function of a cell survival repair gene such as, but not limited to RecA, RecB, RecC, Spot or RelA. In another embodiment, an inhibitor-engineered bacteriophages can comprise at least 2, 3, 4, 5 or more, for example 8 different nucleic acids encoding inhibitors to antibiotic resistance genes or cell survival repair genes, such as at least 2, 3, 4, 5 or more selected from the group, but not limited to, cat, vanA, mecD, RecA, RecB, RecC, Spot or RelA and other antibiotic resistance genes or cell survival repair genes. In some embodiments of this aspect and all aspects described herein, an agent encoded by the nucleic acid of an inhibitor-engineered bacteriophage is a protein which inhibits an antibiotic resistance gene and/or cell survival gene or encodes an RNA-inhibitor (RNAi) agent which inhibits the translation and expression of an antibiotic resistance gene and/or cell survival gene.

Another aspect of the present invention relates to an engineered bacteriophage which comprises a nucleic acid encoding a repressor protein, or fragment thereof of a bacterial SOS response gene, or an agent (such as a protein) which inhibits a non-SOS pathway bacterial defense gene and are referred to herein as “repressor-engineered bacteriophages.” In some embodiments, the repressor of an SOS response gene is, for example but not limited to, lexA, or modified version thereof. In some embodiments, the SOS response gene is, for example but is not limited to marRAB, arcAB and lexO. In some embodiments of this aspect and all other aspects described herein, an inhibitor of a non-SOS pathway bacterial defense gene is soxR, or modified version thereof. In some embodiments of this aspect and all other aspects described herein, an inhibitor of a non-SOS pathway bacterial defense gene is selected from the group of: marR, arc, soxR, fur, crp, icdA or craA or ompA or modified version thereof. In other embodiments of this aspect of the invention, an agent encoded by the nucleic acid of a repressor engineered bacteriophage which inhibits a non-SOS defense gene can inhibit any gene listed in Table 2. In some embodiments, a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can be used in combination with selected antimicrobial agents, for example, where the repressor-engineered bacteriophage encodes an agent which inhibits a gene listed in Table 2A, such a repressor-engineered bacteriophage can be used in combination with a ciprofloxacin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 4B can be used in combination with a vancomycin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 2C, 2D, 2E, 2F and 2G can be used in combination with a rifampicin antimicrobial agent, or a ampicillin antimicrobial agent or a sulfmethaxazone antimicrobial agent or a gentamicin antimicrobial agent or a metronidazole antimicrobial agent, respectively, or a variant or analogue thereof.

Another aspect of the present invention relates to an engineered bacteriophage which comprises a nucleic acid encoding an agent, such as but not limited to a protein, which increases the susceptibility of a bacteria to an antimicrobial agent. Such herein engineered bacteriophage which comprises a nucleic acid encoding an agent which increases the susceptibility of a bacteria to an antimicrobial agent can be referred to herein as an “susceptibility agent-engineered bacteriophage” but are also encompassed under the definition of a “repressor-engineered bacteriophage” In some embodiments of this aspect, and all other aspects described herein, such an agent which increases the susceptibility of a bacteria to an antimicrobial agent is referred to as a “susceptibility agent” and refers to any agent which increases the bacteria's susceptibility to the antimicrobial agent by at least about 10% or at least about 15%, or at least about 20% or at least about 30% or at least about 50% or more than 50%, or any integer between 10% and 50% or more, as compared to the use of the antimicrobial agent alone. In one embodiment, a susceptibility agent is an agent which specifically targets a bacteria cell. In another embodiment, a susceptibility agent modifies (i.e. inhibits or activates) a pathway which is specifically expressed in bacterial cells. In one embodiment, a susceptibility agent is an agent which has an additive effect of the efficacy of the antimicrobial agent (i.e. the agent has an additive effect of the killing efficacy or inhibition of growth by the antimicrobial agent). In a preferred embodiment, a susceptibility agent is an agent which has a synergistic effect on the efficacy of the antimicrobial agent (i.e. the agent has a synergistic effect of the killing efficacy or inhibition of growth by the antimicrobial agent).

In one embodiment, a susceptibility agent increases the entry of an antimicrobial agent into a bacterial cell, for example, a susceptibility agent is a porin or porin-like protein, such as but is not limited to, protein OmpF, and Beta barrel porins, or other members of the outer membrane porin (OMP)) functional superfamily which include, but are not limited to those disclosed in world wide web site: “//biocyc.org/ECOLI/NEW-IMAGE?object=BC-4.1.B”, or a OMP family member listed in Table 3 as disclosed herein, or a variant or fragment thereof. In another embodiment, a susceptibility agent is an agent, such as but not limited to a protein, which increases iron-sulfur clusters in the bacteria cell and/or increases oxidative stress or hydroxyl radicals in the bacteria. Examples of a susceptibility agent which increases the iron-sulfur clusters include agents which modulate (i.e. increase or decrease) the Fenton reaction to form hydroxyl radicals, as disclosed in Kahanski et al., Cell, 2007, 130; 797-810, which is incorporated herein by reference in its entirety. Examples of a susceptibility agent to be expressed by a susceptibility-engineered bacteriophage include, for example, those listed in Table 4, or a fragment or variant thereof or described in world-wide-web site “biocyc.org/ECOLI/NEW-IMAGE?type=COMPOUND&object=CPD-7”

In some embodiments, a susceptibility agent is not a chemotherapeutic agent. In another embodiment, a susceptibility agent is not a toxin protein, and in another embodiment, a susceptibility agent is not a bacterial toxin protein or molecule.

Accordingly, the inventors have developed a modular design strategy in which bacteriophages are engineered to have enhanced capacity to kill bacteria to disable or deactivate the bacteria's natural resistance genes to antimicrobial agents or phage infection. In some embodiments, the bacteriophages can be engineered or modified to express (i) at least one inhibitor to at least one bacterial resistance gene and/or cell survival gene, or (ii) at least one inhibitor (such as, but not limited to a repressor) at least one SOS response gene or bacterial defense gene in bacteria, or (iii) a susceptibility agent which increases the susceptibility of a bacterial cell to an antimicrobial agent.

In some embodiments, any one of these engineered bacteriophages, used alone, or in any combination can be used with at least one antimicrobial agent. For example, one aspect discussed herein relates to an engineered bacteriophage which expresses a nucleic acid inhibitor, such as an antisense nucleic acid inhibitor or antisense RNA (asRNA) which inhibits at least one, or at least two or at least three antibiotic genes and/or a cell survival gene, such as, but not limited to cat, vanA, mecD, RecA, RecB, RecC, Spot or RelA. In another aspect, an engineered bacteriophage can express an repressor, or fragment thereof, of at least one, or at least two or at least three SOS response genes, such as, but not limited to lexA, marR, arc, soxR, fur, crp, icdA, craA or ompA.

The inventors also demonstrated that a repressor-engineered bacteriophage and/or an inhibitor-engineered bacteriophage and/or a susceptibility agent-engineered bacteriophage can reduce the number of antibiotic-resistant bacteria in a population and act as a strong adjuvant for a variety of other bactericidal antibiotics, such as for example, but not limited to gentamicin and ampicillin.

In some embodiments of all aspects of the invention, any engineered bacteriophage disclosed herein, such as repressor-engineered bacteriophage and/or an inhibitor-engineered bacteriophage and/or a susceptibility agent-engineered bacteriophage as discussed herein can additionally comprise a least one of the degrading enzymes effective at degrading bacteria biofilms, such as effective EPS-degrading enzymes specific to the target biofilm, particularly, for example, dispersin B (DspB) which is discussed in PCT application PCT/US2005/032365 and U.S. application Ser. No. 12/337,677, which are incorporated herein by reference.

Also discussed herein is the generation of a diverse library of engineered bacteriophages described herein, such as a library of repressor-engineered bacteriophage and/or an inhibitor-engineered bacteriophage and/or a susceptibility agent-engineered bacteriophages which are capable of acting as adjuvants or to enhance antimicrobial agents, which is advantageous than trying to isolate such bacteriophages that function as adjuvants from the environment. By multiplying within the bacterial colony or biofilm and hijacking the bacterial machinery, inhibitor engineered bacteriophages achieves high local concentrations of both enzyme and lytic phage to target multiple biofilm components, even with small initial phage inoculations.

Rapid bacteriophage (also referred to as “phage” herein) replication with subsequent bacterial lysis and expression of inhibitors of SOS genes renders this a two-pronged attack strategy for use in combination with antimicrobial agents for an efficient, autocatalytic method for inhibiting bacteria and/or removing bacterial biofilms in environmental, industrial, and clinical settings.

Also disclosed herein is a method for the combined use of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility agent-engineered bacteriophage with at least one antimicrobial agent. The inventors have demonstrated that the combined use of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility agent-engineered bacteriophage is at least 4.5 orders of magnitude more efficient than use of the antimicrobial agent alone, and at least two orders of magnitude more efficient at killing or eliminating the bacteria as compared to use of an antimicrobial agent with a non-engineered bacteriophage alone (i.e. an antimicrobial agent in the presence of a bacteriophage which is not an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or susceptibility agent-engineered bacteriophage). Thus, the inventors have demonstrated a significant and surprising improvement over the combined use of non-engineered bacteriophages and antimicrobial agents as therapies described in prior art. The inventors have also demonstrated that use of such engineered bacteriophages as disclosed herein, such as the inhibitor-engineered bacteriophages or repressor-engineered bacteriophages are very effective at reducing the number of antibiotic resistant bacterial cells which can develop in the presence of sub-inhibitory antimicrobial drug concentrations.

Also, one significant advantage of the present invention as compared to methods using non-engineered bacteriophages in combination with antimicrobial agents is that the use of the engineered bacteriophages as disclosed herein with antimicrobial agents allows one to significantly reduce or eliminate a population of persister cells. For example, the administration or application of an engineered bacteriophage as disclosed herein after initial treatment with an antimicrobial agent can reduce or eliminate a population of persister cells. Furthermore, the inventors have discovered that an engineered bacteriophage as disclosed herein, such as an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or susceptibility agent-engineered bacteriophage can reduce the number of antibiotic resistant mutant bacteria that survive in a bacterial population exposed to one or more antimicrobial agents, and therefore the engineered bacteriophages described herein are effective at reducing the number of antibiotic resistant cells which develop in the presence of sub-inhibitory antimicrobial agent drug concentrations.

Another advantage of the present invention is that it allows one to reduce or eliminate multiple applications of the composition during the treatment of a surface having a bacterial biofilm.

One aspect of the present invention relates to engineering or modification of any bacteriophage strain or species to generate the engineered bacteriophages disclosed herein. For example, an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or susceptibility agent-engineered bacteriophage can be any bacteriophage known by a skilled artisan. For example, in one embodiment, the bacteriophage is a lysogenic bacteriophage, for example but not limited to a M13 bacteriophage. In another embodiment, the bacteriophage is a lytic bacteriophage such as, but not limited to T7 bacteriophage. In another embodiment, the bacteriophage is a phage K or a Staphylococcus phage K for use against bacterial infections of methicillin-resistant S. aureus.

One aspect of the present invention relates to an engineered lysogenic M13 bacteriophage comprising a nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene.

Another aspect of the present invention relates to an engineered lysogenic M13 bacteriophage comprising a nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and/or an inhibitor to a non-SOS bacterial defense gene.

Another aspect of the present invention relates to an engineered lysogenic M13 bacteriophage comprising a nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one agent that increases the susceptibility of a bacterial cell to an antimicrobial gene.

Another aspect of the present invention relates to an engineered lytic T7 bacteriophage comprising a nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one agent that inhibits at least one antibiotic resistance gene and/or at least one cell survival repair gene.

Another aspect of the present invention relates to an engineered lytic T7 bacteriophage comprising a nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and/or an inhibitor to a non-SOS bacterial defense gene.

Another aspect of the present invention relates to an engineered lytic T7 bacteriophage comprising a nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one agent that increases the susceptibility of a bacterial cell to an antimicrobial gene.

In some embodiments, an antibiotic resistance gene is selected from the group comprising cat, vanA or mecD or variants thereof. In some embodiments, a cell survival gene is selected from the group comprising RecA, RecB, RecC, spot, RelA or variants thereof.

In some embodiments of all aspects described herein, a bacteriophage can comprise an agent which is selected from a group comprising, siRNA, antisense nucleic acid, asRNA, RNAi, miRNA and variants thereof. In some embodiments, the bacteriophage comprises an as RNA agent.

In some embodiments, the bacteriophage comprises a nucleic acid encoding at least two agents that inhibit at least two different cell survival repair genes, for example but not limited to, at least two agents that inhibit at least two of RecA, RecB or RecC.

In some embodiments, the repressor of a SOS response gene is selected from the group comprising lexA, marR, arcR, soxR, fur, crp, icdA, craA, ompF or variants or fragments thereof. In some embodiments, the repressor is LexA and in some embodiments, the repressor is csrA or omF, and in some embodiments the bacteriophage can comprise the nucleic acid encoding a mixture of LexA, csrA or omF in any combination. For example, in some embodiments, the bacteriophage can comprise the nucleic acid encoding at least two different repressors of at least one SOS response gene, such as, but not limited to the bacteriophage can comprise the repressors csrA and ompF or variants or homologues thereof.

Another aspect of the present invention relates to a method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (i) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene, and (ii) at least one antimicrobial agent.

Another aspect of the present invention relates to a method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (i) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene, and (ii) at least one antimicrobial agent.

Another aspect of the present invention relates to a method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (i) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one agent which increases the susceptibility of a bacterial cell to a antimicrobial agent, and (ii) at least one antimicrobial agent.

In some embodiments of all aspects described herein, a bacteriophage useful in the methods disclosed herein and used to generate an engineered bacteriophage, such as a inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage is any bacteriophage know by a skilled artisan. A non-limiting list of examples of bacteriophages which can be used are disclosed in Table 5 herein. In one embodiment, the bacteriophage is a lysogenic bacteriophage such as, for example a M13 lysogenic bacteriophage. In alternative embodiments, a bacteriophage useful in all aspects disclosed herein is a lytic bacteriophage, for example but not limited to a T7 lytic bacteriophage. In one embodiment, a bacteriophage useful in all aspects disclosed herein is a SP6 bacteriophage or a phage K, or a staphylococcus phage K bacteriophage.

In some embodiments, administration of any engineered-bacteriophage as disclosed herein and the antimicrobial agent occurs simultaneously, and in alternative embodiments, the administration of a engineered-bacteriophage occurs prior to the administration of the antimicrobial agent. In other embodiments, the administration of an antimicrobial agent occurs prior to the administration of a engineered-bacteriophage.

In some embodiments, antimicrobial agents useful in the methods as disclosed herein are quinolone antimicrobial agents, for example but not limited to, antimicrobial agents selected from a group comprising ciprofloxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin or variants or analogues thereof. In some embodiments, an antimicrobial agents useful in the methods as disclosed herein is ofloxacin or variants or analogues thereof.

In some embodiments, antimicrobial agents useful in the methods as disclosed herein are aminoglycoside antimicrobial agents, for example but not limited to, antimicrobial agents selected from a group consisting of amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin or variants or analogues thereof. In some embodiments, an antimicrobial agent useful in the methods as disclosed herein is gentamicin or variants or analogues thereof.

In some embodiments, antimicrobial agents useful in the methods as disclosed herein are β-lactam antibiotic antimicrobial agents, such as for example but not limited to, antimicrobial agents selected from a group consisting of penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof. In some embodiments, an antimicrobial agent useful in the methods as disclosed herein is ampicillin or variants or analogues thereof.

Another aspect of the present invention relates to a composition comprising a lysogenic M13 bacteriophage comprising a nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene and at least one antimicrobial agent. Another aspect of the present invention relates to a composition comprising a lysogenic M13 bacteriophage comprising a nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and at least one antimicrobial agent.

Another aspect of the present invention relates to a composition comprising a lytic T7 bacteriophage comprising a nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene and at least one antimicrobial agent. Another aspect of the present invention relates to a composition a lytic T7 bacteriophage comprising a nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and at least one antimicrobial agent.

In some embodiments, the composition comprises antimicrobials agents such as, for example but not limited to, quinolone antimicrobial agents and/or aminoglycoside antimicrobial agents and/or β-lactam antimicrobial agent, for example, but not limited to, antimicrobial agents selected from a group comprising ciprofloxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin, amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin, penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof.

In some embodiments, the composition comprises at least one inhibitor-engineered bacteriophage and/or at least one repressor-engineered bacteriophage as disclosed herein.

Another aspect of the present invention relates to a kit comprising a lysogenic M13 bacteriophage comprising the nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene. Another aspect of the present invention relates a kit comprising a lysogenic M13 bacteriophage comprising the nucleic acid operatively linked to a M13 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response.

Another aspect of the present invention relates a kit comprising a lytic T7 bacteriophage comprising the nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene. Another aspect of the present invention relates a kit comprising a lytic T7 bacteriophage comprising the nucleic acid operatively linked to a T7 promoter, wherein the nucleic acid encodes at least one repressor of a SOS response.

In some embodiments, the methods and compositions as disclosed herein are administered to a subject. In some embodiments, the methods to inhibit or eliminate a bacterial infection comprising administering the compositions as disclosed herein to a subject, wherein the bacteria are present in the subject. In some embodiments, the subject is a mammal, for example but not limited to a human.

In some embodiments, any of the bacteriophages as disclosed herein are useful in combination with at least one antimicrobial agent to reduce the number of bacteria as compared to use of the antimicrobial agent alone. In some embodiments, any of the bacteriophages as disclosed herein are useful in combination with at least one antimicrobial agent to inhibit or eliminate a bacterial infection, such as for example inhibit or eliminate a bacteria present a biofilm.

In some embodiments, the present invention relates to methods to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (i) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene, and (ii) at least one antimicrobial agent. In some embodiments, the bacteria is in a biofilm.

BRIEF DESCRIPTION OF FIGURES

FIGS. 1A-1E show engineered φ_(lexA3) bacteriophage enhances killing of wild-type E. coli EMG2 bacteria by bactericidal antibiotics. FIG. 1A shows a schematic of combination therapy with engineered phage and antibiotics. Bactericidal antibiotics induce DNA damage via hydroxyl radicals, leading to induction of the SOS response. SOS induction results in DNA repair and can lead to survival (Kohanski et al., 2007, Cell 130, 797-8108). Engineered phage carrying the lexA3 gene (φ_(lexA3)) under the control of the synthetic promoter PLtetO and a ribosome-binding sequence (Lutz et al., 1997, Nucleic Acids Res 25, 1203-121027) acts as an antibiotic adjuvant by suppressing the SOS response and increasing cell death. FIG. 1B shows a killing curves for no phage (diamonds), unmodified phage φ_(unmod) (squares), and engineered phage φ_(lexA3) (circles) with 60 ng/mL ofloxacin [oflox] (solid lines, closed symbols). 10⁸ PFU/mL phage was used. A growth curve for E. coli EMG2 with no treatment is shown for comparison (dotted line, open symbols). φ_(lexA3) greatly enhanced killing by ofloxacin by 4 hours of treatment. FIG. 1C is a ofloxacin dose response showing that φ_(lexA3) (circles with solid line) increases killing even at low levels of drug compared with no phage (diamonds with dash-dotted line) and φunmod (squares with dashed line). 10⁸ PFU/mL phage was used. FIG. 1D shows killing curves for no phage (diamonds), φ_(unmod)(squares), and φ_(lexA3) (circles) with 5 μg/mL gentamicin [gent]. 10⁹ PFU/mL phage was used. φ_(lexA3) phage greatly increases killing by gentamicin. FIG. 1E shows killing curves for no phage (diamonds), φ_(unmod) (squares), and φ_(lexA3) (circles) with 5 μg/mL ampicillin [amp]. 10⁹ PFU/mL phage was used. φ_(lexA3) phage greatly increases killing by ampicillin.

FIG. 2 shows that engineered φ_(lexA) bacteriophage enhances killing of quinolone-resistant E. coli RFS289 bacteria by ofloxacin. Killing curves for no phage (diamonds), unmodified phage funmod (squares), and engineered phage φ_(lexA3) (circles) with 1 μg/mL ofloxacin [oflox] (solid lines, closed symbols). 10⁸ PFU/mL phage was used. φ_(lexA3) greatly enhanced killing by ofloxacin by 1 hour of treatment.

FIGS. 3A-3B show that engineered φ_(lexA3) bacteriophage increases survival of mice infected with bacteria. FIG. 3A shows a schematic of a female Charles River CD-1 mice inoculated with intraperitoneal injections of 8.8×10⁷ CFU/mouse E. coli EMG2 bacteria. After 1 hour, the mice received either no treatment or intravenous treatment with no phage, unmodified phage φ_(unmod), or engineered phage φ_(lexA3) with 0.2 mg/kg ofloxacin. 10⁹ PFU/mouse phage was used. The mice were observed for 5 days and deaths were recorded at the end of each day to generate survival curves. FIG. 3B shows survival curves for infected mice treated with phage and/or ofloxacin demonstrate that engineered phage φ_(lexA3) plus ofloxacin (closed circles with solid line) significantly increases survival of mice compared with unmodified phage funmod plus ofloxacin (closed squares with solid line), no phage plus ofloxacin (closed diamonds with solid line), and no treatment (open diamonds with dashed line).

FIGS. 4A-4B show box-and-whisker plot of the total number of E. coli EMG2 cells in 60 observations that were resistant to 100 ng/mL ofloxacin after growth under various conditions (bars indicate medians, diamonds represent outliers). FIG. 4A shows cells grown with no phage and no ofloxacin for 24 hours had very low numbers of antibiotic-resistant cells. Cells grown with no phage and 30 ng/mL ofloxacin for 24 hours had high numbers of resistant cells due to growth in subinhibitory drug concentrations (Martinez et al., 2000, Antimicrob. Agents Chemother. 44, 1771-177730). Cells grown with no phage and 30 ng/mL ofloxacin for 12 hours followed by 10⁹ PFU/mL unmodified phage funmod and 30 ng/mL ofloxacin for 12 hours exhibited a modest level of antibiotic-resistant bacteria. Cells grown with no phage and 30 ng/mL ofloxacin for 12 hours followed by 10⁹ PFU/mL φ_(lexA) and 30 ng/mL ofloxacin for 12 hours exhibited a low level of antibiotic-resistant bacteria, close to the numbers seen with no ofloxacin and no phage. FIG. 4B shows a zoomed-in version of box-and-whisker plot in (a) for increased resolution around low total resistant cell counts confirms that φ_(lexA3) with 30 ng/mL ofloxacin treatment reduced the number of resistant cells to levels similar to that of no ofloxacin with no phage.

FIGS. 5A-5D show engineered bacteriophage targeting single and multiple gene networks (other than the SOS network) as adjuvants for ofloxacin treatment [oflox]. FIG. 5A show Ofloxacin stimulates superoxide generation, which is normally countered by the oxidative stress response, coordinated by SoxR (Kohanski et al., 2007, Cell 130, 797-8108). Engineered phage producing SoxR (φ_(soxR)) enhances ofloxacin-based killing by disrupting regulation of the oxidative stress response. FIG. 5B show killing curves for no phage (diamonds), unmodified phage φ_(unmod) (squares), and engineered phage φ_(soxR) (downwards-facing triangles) with 60 ng/mL ofloxacin (solid lines, closed symbols). 10₈ PFU/mL phage was used. The killing curve for funmod and a growth curve for E. coli EMG2 with no treatment (dotted line, open symbols) are reproduced from FIG. 1B for comparison and show that φ_(soxR) enhances killing by ofloxacin. FIG. 5C CsrA suppresses the biofilm state in which bacterial cells tend to be more resistant to antibiotics (Jackson et al., 2002, J. Bacteriol. 184, 290-30135). OmpF is a porin used by quinolones to enter bacterial cells (Hirai K, et al., 1986, Antimicrob. Agents Chemother. 29, 535-53837). Engineered phage producing both CsrA and OmpF simultaneously (φ_(csrA-ompF)) enhances antibiotic penetration via OmpF and represses biofilm formation and antibiotic tolerance via CsrA to produce an improved dual targeting adjuvant for ofloxacin. FIG. 5D shows killing curves for φ_(csrA) (diamonds), φ_(ompF) (squares), and φ_(csrA-ompF) (upwards-facing triangles) with 60 ng/mL ofloxacin. 10⁸ PFU/mL phage was used. Phage expressing both csrA and ompF (φ_(csrA-ompF)) is a better adjuvant for ofloxacin than phage expressing csrA (φ_(csrA)) or ompF alone (φ_(ompF)).

FIGS. 6A-6D show engineered bacteriophage targeting non-SOS systems in E. coli as adjuvants for ofloxacin treatment [oflox]. FIG. 6A shows a killing curves for no phage (black diamonds), 10⁸ PFU/mL unmodified M13mp18 (i.e. φ_(unmod)) (squares), and 10⁸ PFU/mL M13mp18-soxR (i.e. φ_(SoxR)) (downwards-facing triangles) without ofloxacin (dotted lines, open symbols) or with 60 ng/mL ofloxacin (solid lines, closed symbols). Killing curves for no phage and unmodified m13mp18 phage (φ_(unmod)) are reproduced from FIG. 1B for comparison and demonstrate that M13mp18-soxR (i.e. φ_(soxR)) enhances killing by ofloxacin. 10⁸ PFU/mL represents an MOI of approximately 1:10. FIG. 6B shows a killing curves for 10⁸ PFU/mL M13 mp18-csrA (φ_(csrA)) (black diamonds), 10⁸ PFU/mL M13mp18-ompF (φ_(ompF)) (squares), and 10⁸ PFU/mL M13mp18-csrA-ompF (φ_(csrA-ompF)) (upwards-facing triangles) without ofloxacin (dotted lines, open symbols) or with 60 ng/mL ofloxacin (solid lines, closed symbols). Phage expressing both csrA and ompF (M13mp18-csrA-ompF or φ_(csrA-ompF)) is a better adjuvant for ofloxacin than phage expressing csrA alone (M13mp18-csrA; φ_(csrA)) or ompF alone (M13mp18-ompF; φ_(ompF)). 10⁸ PFU/mL represents an MOI of approximately 1:10. FIG. 6C shows a phage dose response which demonstrates that both M13mp18-soxR (downwards-facing triangles with solid line) and M13mp18-csrA-ompF (upwards-facing triangles with solid line) are effective as adjuvants for ofloxacin (60 ng/mL) over a wide range of initial inoculations. Phage dose response curves for no phage (dash-dotted line) and unmodified M13mp18 phage (squares with dashed line) are reproduced from FIG. 1 c for comparison. FIG. 6D shows a Ofloxacin dose response with 10⁸ PFU/mL that shows that both M13mp18-soxR (downwards-facing triangles with solid line) and M13mp18-csrA-ompF (upwards-facing triangles with solid line) improve killing throughout a range of drug concentrations. Ofloxacin dose response curves for no phage (diamonds with dash-dotted line) and unmodified M13mp18 phage (squares with dashed line) are reproduced from FIG. 1D for comparison.

FIGS. 7A-7D show histograms of the total number of E. coli cells in 60 observations that were resistant to 100 ng/mL ofloxacin after growth under various conditions. FIG. 7A shows cells grown with no phage and no ofloxacin for 24 hours had very low numbers of antibiotic-resistant cells. Inset of FIG. 8A shows the distribution of observations with total resistant cells between 0 and 50 for increased resolution and demonstrates that many observations were devoid of antibiotic-resistant bacteria. FIG. 7B shows cells grown with no phage and 30 ng/mL ofloxacin for 24 hours had high numbers of resistant cells, demonstrating a large increase in antibiotic resistance due to growth in subinhibitory drug concentrations¹⁷. No inset is shown because no observations had less than 50 resistant cells. FIG. 7C shows cells grown with no phage and 30 ng/mL ofloxacin for 12 hours followed by 10⁹ PFU/mL unmodified M13mp18 phage and 30 ng/mL ofloxacin for 12 hours exhibited a modest level of antibiotic-resistant bacteria. Inset of FIG. 7C shows the distribution of observations with total resistant cells between 0 and 50 for increased resolution and demonstrates that no observations were devoid of antibiotic-resistant bacteria. FIG. 7D shows cells grown with no phage and 30 ng/mL ofloxacin for 12 hours followed by 10⁹ PFU/mL M13mp18-lexA3 and 30 ng/mL ofloxacin for 12 hours exhibited a low level of antibiotic-resistant bacteria compared to no phage and 30 ng/mL ofloxacin in FIG. 7D, and unmodified M13mp18 and 30 ng/mL ofloxacin in FIG. 8C. Inset of FIG. 7D shows the distribution of observations with total resistant cells between 0 and 50 for increased resolution and demonstrates that M13mp18-lexA3 treatment reduced the number of resistant cells under 30 ng/mL ofloxacin to levels similar to that of 0 ng/mL ofloxacin in FIG. 8A.

FIGS. 8A-8B shows engineered M13mp18-lexA3 bacteriophage enhances killing by other bactericidal drugs. FIG. 8A shows killing curves for no phage (diamonds), 10⁹ PFU/mL unmodified M13mp18 (squares), and 10⁹ PFU/mL M13mp18-lexA3 (circles) with 5 μg/mL gentamicin [gent]. Engineered M13mp18-lexA3 phage greatly improved killing by gentamicin. 10⁹ PFU/mL represents an MOI of approximately 1:1. FIG. 8B shows a killing curves for no phage (diamonds), 10⁹ PFU/mL unmodified M13mp18 (squares), and 10⁹ PFU/mL M13mp18-lexA3 (circles) with 5 μg/mL ampicillin [amp]. Engineered M13mp18-lexA3 phage greatly improved killing by ampicillin 10⁹ PFU/mL represents an MOI of approximately 1:1.

FIGS. 9A-9F show genomes of unmodified M13mp18 bacteriophage and engineered bacteriophage. Engineered bacteriophage were constructed by inserting genetic modules under the control of a synthetic promoter (P_(L)tetO) and ribosome-binding sequence (RBS) in between Sad and PvuI restriction sites. A terminator (Term_(T1)) ends transcription of the respective gene(s). FIG. 9A shows unmodified M13mp18 (φ_(unmod)) contains lacZ to allow blue-white screening of engineered bacteriophage. FIG. 9B shows engineered M13mp18 bacteriophage expressing lexA3 (φ_(lexA3)). FIG. 9C shows engineered M13mp18 bacteriophage expressing soxR (φ_(soxR)). FIG. 9D shows engineered M13mp18 bacteriophage expressing csrA (φ_(csrA)). FIG. 9E shows engineered M13mp18 bacteriophage expressing ompF (φ_(ompF)). FIG. 9F shows engineered M13mp18 bacteriophage expressing csrA and ompF (φ_(csrA-ompF)).

FIGS. 10A-10E show flow cytometry of cells with an SOS-responsive GFP plasmid exposed to no phage (black lines), unmodified phage φ_(unmod) (red lines), or engineered phage φ_(lexA3) (blue lines) for 6 hours with varying doses of ofloxacin. 10⁸ plaque forming units per mL (PFU/mL) of phage were applied. Cells exposed to no phage or φunmod showed similar SOS induction profiles, whereas cells with φ_(lexA3) exhibited significantly suppressed SOS responses. FIG. 10A shows 0 ng/mL ofloxacin treatment. FIG. 10B shows 20 ng/mL ofloxacin treatment. FIG. 10C show 60 ng/mL ofloxacin treatment. FIG. 10D show 100 ng/mL ofloxacin treatment. FIG. 10E shows 200 ng/mL ofloxacin treatment.

FIG. 11 shows persister killing assay demonstrates that engineered bacteriophage can be applied to a previously drug-treated population to increase killing of surviving persister cells. After 3 hours of 200 ng/mL ofloxacin treatment, no phage, 10⁹ PFU/mL control M13mp18 phage, or 10⁹ PFU/mL engineered M13mp18-lexA3 phage were added to the previously drug-treated cultures. Three additional hours later, viable cell counts were obtained and demonstrated that M13mp18-lexA3 was able to reduce persister cell levels better than no phage or control M13mp8 phage.

FIG. 12 shows paired-termini design from Nakashima, et al (2006) Nucleic Acids Res 34: e138, in which the antisense RNA is cloned between the flanking restriction sites at the top of the stem. Reprinted from Nakashima, et al (2006) Nucleic Acids Res 34: e138.

FIG. 13 shows autoregulated negative-feedback module with lexA repressing P_(L)lexO from Morens, et al., (2004) Nature 430: 242-249, can increase the level of lexA expression when lexA is cleaved by recA in response to DNA damage by agents such as ofloxacin.

FIG. 14 shows persistence assay for various constructs in wild-type E. coli EMG2 cells after 8 hours of growth in the presence of 1 mM IPTG followed by 8 hours of treatment with 5 μg/mL ofloxacin. Greatly improved cell killing was generated by the double knockouts, especially P_(L)tetO-recB-asRNA/P_(L)lacO-recA-asRNA and P_(L)tetO-recC-asRNA/P_(L)lacO-recB-asRNA. pZE1L-lexA also reduced the number of surviving cells compared with wild-type E. coli EMG2.

FIG. 15 shows engineered φ_(lexA3) bacteriophage enhances killing of wild-type E. coli EMG2 bacteria by bactericidal antibiotics. Phage dose response shows that φ_(lexA3) (blue circles with solid line) is a strong adjuvant for ofloxacin (60 ng/mL) over a wide range of initial inoculations compared with no phage (black dash-dotted line) and φ_(unmod) (red squares with dashed line). The starting concentration of bacteria was about 10⁹ CFU/mL (data not shown).

FIG. 16 shows persister killing assay demonstrates that engineered bacteriophage can be applied to a previously drug-treated population to increase killing of surviving persister cells. After 3 hours of 200 ng/mL ofloxacin treatment, no phage (black bar), 10⁹ PFU/mL unmodified phage φ_(unmod) (red bar), or 10⁹ PFU/mL engineered phage φ_(lexA)3 (blue bar) were added to the previously drug-treated cultures. Three additional hours later, viable cell counts were obtained and demonstrated that φl_(exA3) was able to reduce persister cell levels better than no phage or φ_(unmod).

FIG. 17 shows mean killing with 60 ng/mL ofloxacin after 12 hours of treatment of E. coli EMG2 biofilms pregrown for 24 hours. Where indicated, 10⁸ PFU/mL of (r) lexA3 bacteriophage was used.

FIG. 18 shows the mean killing with 60 ng/mL ofloxacin after 12 hours of treatment of E. coli EMG2 biofilms pregrown for 24 hours. Where indicated, 10⁸ PFU/mL of φ_(csrA), φ_(ompF), or φ_(csrA-ompF) bacteriophage was used.

FIG. 19 shows an example of a promoter which can be used to express the nucleic acid in the engineered bacteriophage. FIG. 19 shows a P_(LtetO-1) (SEQ ID NO: 32), P_(LlacO-1) (SEQ ID NO: 33), P_(AlacO-1) (SEQ ID NO: 34) and P_(lac/ara-1) (SEQ ID NO: 35) promoters which can be used.

DETAILED DESCRIPTION

As disclosed herein, the inventors have discovered a two pronged strategy to significantly reduce or eliminate a bacterial infection. In particular, the inventors have engineered bacteriophages to be used in combination with an antimicrobial agent, such that the engineered bacteriophage functions as an adjuvant to the antimicrobial agent. Thus, the inventors have engineered bacteriophages to be used in combination with an antimicrobial agent, such that the engineered bacteriophage functions as an adjuvant to at least one antimicrobial agent. In particular, the inventors have engineered bacteriophages to specifically disable (or deactivate) the bacteria's natural resistance mechanisms to the antimicrobial agents and/or phage infection. Accordingly, one aspect of the present invention generally relates to engineered bacteriophages which have been modified or engineered to (i) inhibit at least one bacterial resistance gene, or (ii) to inhibit at least one SOS response gene or bacterial defense gene in bacteria, or (iii) to express a protein which increases the susceptibility of a bacterial cell to an antimicrobial agent. Any one of these engineered bacteriophages, used alone, or in any combination can be used with an antimicrobial agent. Accordingly, the inventors have discovered a method to prevent the development of bacterial resistance to antimicrobial agents and the generation of persistent bacteria by inhibiting the local bacterial synthetic machinery which normally circumvents the antimicrobial effect, by engineering bacteriophages to be used in conjunction (or in combination with) an antimicrobial agent, where an engineered bacteriophage can inhibit an antimicrobial resistance gene, or inhibit a SOS response gene or a non-SOS bacterial defense gene, or express a protein to increase the susceptibility of a bacterial cell to an antimicrobial agent.

Accordingly, one aspect of the present invention relates to the engineered bacteriophages as discussed herein for use in conjunction with (i.e. in combination with) at least one antimicrobial agent, and that the engineered bacteriophages serve as adjuvants to such antimicrobial agents.

One aspect of the present invention relates to a method to potentiate the bacterial killing effect of an antimicrobial agent. In particular, one aspect of the present invention relates to methods and compositions comprising engineered bacteriophages for use in combination with an antimicrobial agent to potentiate the antimicrobial effect and bacterial killing of the antimicrobial agent. Another aspects relates to the use of an engineered bacteriophage as an antibiotic adjuvant. In some embodiments of this and all aspects described herein, an engineered bacteriophage can be used as an antibiotic adjuvant for an aminglycoside antimicrobial agent, such as but not limited to, gentamicin, as antibiotic adjuvants for a β-lactam antibiotic, such as but not limited to, ampicillin, and as an antibiotic adjuvant for a quinolone antimicrobial agent, such as but not limited to, ofloxacin. In one embodiment of this aspect and all aspects described herein, an engineered bacteriophage can function as an antimicrobial adjuvant or antibiotic adjuvant for at least 2, at least 3, at least 4, at least 5, least 6, at least 7, at least 8, at least 9 or at least 10 or more different antimicrobial agents at any one time. In some embodiments, any of the engineered bacteriophages as disclosed herein can used in combination with at least one or more antimicrobial agent, for example an engineered bacteriophage as disclosed herein can used in combination with at least 2, 3, 4, 5, 6, 7, 8, 9 or 10 or more different antimicrobial agents.

In one aspect of the present invention, an engineered bacteriophage as disclosed herein can comprise a nucleic acid encoding an agent which inhibits at least one bacterial gene involved in the development of antibiotic resistance. In another embodiment of this aspect and all aspects described herein, an engineered bacteriophage can comprise a nucleic acid encoding an agent which inhibits at least one gene involved in bacterial cell survival repair. As discussed previously, such engineered bacteriophages which comprise a nucleic acid encoding an agent which inhibits at least one bacterial gene involved in antibiotic resistance and/or at least one bacterial gene involved in cell survival are referred to herein as “inhibitor-engineered bacteriophages”. In some embodiments of this aspect and all aspects discussed herein, an agent which inhibits an antibiotic resistance bacterial gene can inhibit the gene expression and/or protein function of antibiotic resistance genes such as, but not limited to cat, vanA or mecD. In some embodiments of this aspect and all aspects discussed herein, an agent which inhibits a bacterial cell survival gene can inhibit the gene expression and/or protein function of a cell survival repair gene such as, but not limited to RecA, RecB, RecC, Spot or RelA.

In some embodiments of this aspect and all aspects described herein, an inhibitor-engineered bacteriophage can comprise a nucleic acid encoding an agent which inhibits at least one gene involved in antibiotic resistance and/or cell survival repair. In one embodiment of this aspect and all aspect described herein, an inhibitor-engineered bacteriophage can comprise at least 2, 3, 4, 5 or even more, for example 10 different nucleic acids which inhibit at least one gene, for example, 2, 3, 4, 5 or up to 10 genes involved in antibiotic resistance and/or cell survival repair. In some embodiment of this aspect, an inhibitor-engineered bacteriophage can comprise at least 2, 3, 4, 5 or more, for example 8 different nucleic acids encoding inhibitors to at least one antibiotic resistance gene or to at least one cell survival repair gene, such as at least 2, 3, 4, 5 or more selected from the group, but not limited to, cat, vanA, mecD, RecA, RecB, RecC, Spot or RelA and other antibiotic resistance genes or cell survival repair genes. In some embodiments, any or all different combinations of inhibitors of antibiotic resistance genes and/or cell survival repair genes can be present in an inhibitor-engineered bacteriophage.

In another aspect of the present invention, an engineered bacteriophage can comprise at least one nucleic acid encoding a repressor protein, or fragment thereof of a bacterial SOS response gene, or an agent (such as a protein) which inhibits a non-SOS pathway bacterial defense gene and are referred to herein as “repressor-engineered bacteriophages.” In some embodiments, the repressor of an SOS response gene is, for example but not limited to, lexA, or modified version thereof. In some embodiments, the SOS response gene is, for example but is not limited to marRAB, arcAB and lexO. In some embodiments of this aspect and all other aspects described herein, an inhibitor of a non-SOS pathway bacterial defense gene can be any agent, such as but not limited to a protein or an RNAi agent, such as antisense to a non-SOS gene such as, for example but not limited to soxR, or modified version thereof. In some embodiments of this aspect and all other aspects described herein, an repressor, such as an agent which inhibits a non-SOS pathway bacterial defense gene inhibits, for example genes selected from the group of: marR, arc, soxR, fur, crp, icdA or craA or ompA or modified version thereof. In other embodiments of this aspect of the invention, a nucleic acid of a repressor engineered bacteriophage is an agent which inhibits a non-SOS defense gene, for example the repressor agent can inhibit any gene, or any combination of genes listed in Table 2. In some embodiments, a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can be used in combination with selected antimicrobial agents, for example, where the repressor-engineered bacteriophage encodes an agent which inhibits a gene listed in Table 2A, such a repressor-engineered bacteriophage can be used in combination with a ciprofloxacin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 4B can be used in combination with a vancomycin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 2C, 2D, 2E, 2F and 2G can be used in combination with a rifampicin antimicrobial agent, or a ampicillin antimicrobial agent or a sulfmethaxazone antimicrobial agent or a gentamicin antimicrobial agent or a metronidazole antimicrobial agent, respectively, or a variant or analogue thereof.

In some embodiments of this aspect an all other aspects discussed herein, a repressor is, for example but not limited to, lexA, marR, arc, soxR, fur, crp, icdA, craA or ompA or a modified version thereof. In some embodiments, the SOS response gene is, for example but is not limited to marRAB, arcAB and lexO.

In some embodiments of this aspect and all other aspects described herein, a repressor-engineered bacteriophage can comprise at least 2, 3, 4, 5 or more, for example 8 different nucleic acids encoding different repressors of SOS response genes, such as at least 2, 3, 4, 5 or more selected from the group, but not limited to, lexA, marRAB, arcAB and lexO and other repressors of SOS response genes, or least 2, 3, 4, 5 or more, for example 8 different nucleic acids encoding different repressors (i.e. inhibitors) of non-SOS defense genes. In some embodiments, a repressor engineered bacteriophage can comprise any or all different combinations of repressors of SOS genes described herein and/or any and all different combinations of inhibitors non-SOS defense genes listed in Tables 2 and 2A-2G can be present in a repressor-engineered bacteriophage.

In another aspect of the present invention, an engineered bacteriophage can comprise at least one nucleic acid encoding an agent, such as but not limited to a protein, which increases the susceptibility of a bacteria to an antimicrobial agent. Such herein engineered bacteriophage which comprises a nucleic acid encoding an agent which increases the susceptibility of a bacteria to an antimicrobial agent can be referred to herein as an “susceptibility agent-engineered bacteriophage” but are also encompassed under the definition of a “repressor-engineered bacteriophage” In some embodiments of this aspect, and all other aspects described herein, such an agent which increases the susceptibility of a bacteria to an antimicrobial agent is referred to as a “susceptibility agent” and refers to any agent which increases the bacteria's susceptibility to the antimicrobial agent by at least about 10% or at least about 15%, or at least about 20% or at least about 30% or at least about 50% or more than 50%, or any integer between 10% and 50% or more, as compared to the use of the antimicrobial agent alone. In one embodiment, a susceptibility agent is an agent which specifically targets a bacteria cell. In another embodiment, a susceptibility agent modifies (i.e. inhibits or activates) a pathway which is specifically expressed in bacterial cells. In one embodiment, a susceptibility agent is an agent which has an additive effect of the efficacy of the antimicrobial agent (i.e. the agent has an additive effect of the killing efficacy or inhibition of growth by the antimicrobial agent). In a preferred embodiment, a susceptibility agent is an agent which has a synergistic effect on the efficacy of the antimicrobial agent (i.e. the agent has a synergistic effect of the killing efficacy or inhibition of growth by the antimicrobial agent).

Accordingly, another aspect of the invention relates to the use of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or a susceptibility-engineered bacteriophage to potentiate the killing effect of antimicrobial agents or stated another way, to enhance the efficacy of antimicrobial agents. An inhibitor-engineered bacteriophages and/or a repressor engineered bacteriophage and/or a susceptibility-engineered bacteriophage is considered to potentiate the effectiveness of an antimicrobial agent if the amount of antimicrobial agent used in combination with an engineered bacteriophage as disclosed herein is reduced by at least about 10% without adversely affecting the result, for example, without adversely effecting the level of antimicrobial activity. In another embodiment, the criteria used to select an inhibitor-engineered bacteriophage and/or a repressor engineered bacteriophage and/or a susceptibility-engineered bacteriophage that potentiates the activity of an antimicrobial agent is a reduction of at least about 10%, . . . or at least about 15%, . . . or at least about 20%, . . . or at least about 25%, . . . or at least about 35%, . . . or at least about 50%, . . . or at least about 60%, . . . or at least about 90% and all integers in between 10-90% of the amount of the antimicrobial agent without adversely effecting the antimicrobial effect when compared to the similar amount without the addition of an inhibitor-engineered bacteriophage and/or repressor engineered bacteriophage and/or a susceptibility-engineered bacteriophage. Stated another way, an inhibitor-engineered bacteriophage and/or repressor engineered bacteriophage and/or a susceptibility-engineered bacteriophage is effective as an adjuvant to an antimicrobial agent when the combination of the antimicrobial agent and the engineered bacteriophage results in about the same level (i.e. within about 10%) of antimicrobial effect at reducing the bacterial infection or killing the bacteria with the reduction in the dose (i.e. the amount) of the antimicrobial agent. Such a reduction in antimicrobial dose can be, for example by about 10%, or about 15%, . . . or about 20%, . . . or about 25%, . . . or about 35%, . . . or about 50%, . . . or about 60%, . . . or more than 60% with the same level of antimicrobial efficacy.

The inventors herein have demonstrated that the engineered bacteriophage can target gene networks that are not directly attacked by antibiotics and by doing so, greatly enhanced the efficacy of antibiotic treatment in bacteria, such as Escherichia coli. The inventors demonstrated that suppressing or inhibiting the bacterial SOS response network with a repressor-engineered bacteriophage can enhance killing by an antimicrobial agent such as an antibiotic, for example but not limited to, ofloxacin, a quinolone drug, by over 2.7 orders of magnitude as compared with a control bacteriophage (i.e. non-engineered bacteriophages) plus ofloxacin, and over 4.5 orders of magnitude compared with ofloxacin alone.

The inventors have also demonstrated herein in Examples 6-8 that a repressor-engineered bacteriophage, which comprises at least one inhibitor to one or more non-SOS genetic networks are also effective antibiotic adjuvants. The inventors also demonstrated that repressor-engineered bacteriophage and/or inhibitor-engineered bacteriophage can reduce the number of antibiotic-resistant bacteria in a population and act as a strong adjuvant for a variety of other bactericidal antibiotics, such as for example, but not limited to gentamicin and ampicillin Thus, the inventors have demonstrated that by selectively targeting gene networks with bacteriophage, one can enhance killing by antibiotics, thus discovering a highly effective new antimicrobial strategy.

DEFINITIONS

For convenience, certain terms employed in the entire application (including the specification, examples, and appended claims) are collected here. Unless defined otherwise, all technical and scientific terms used herein have the same meaning as commonly understood by one of ordinary skill in the art to which this invention belongs.

As used herein, the term “adjuvant” as used herein refers to an agent which enhances the pharmaceutical effect of another agent. As used herein, the bacteriophages as disclosed herein function as adjuvants to antimicrobial agents, such as, but not limited to antibiotic agents, by enhancing the effect of the antimicrobial agents by at least . . . 5%, . . . at least 10%, . . . at least 15%, . . . at least 20%, . . . at least 25%, . . . at least 35%, . . . at least 50%, . . . at least 60%, . . . at least 90% and all amounts in-between as compared to use of the antimicrobial agent alone. Accordingly, the engineered bacteriophages as disclosed herein, such as the inhibitor-engineered bacteriophage and/or repressor engineered bacteriophage function as antimicrobial agent adjuvants.

As used herein, the term “inhibitor-engineered bacteriophage” refers to a bacteriophage that have been genetically engineered to comprise a nucleic acid which encodes an agent which inhibits at least one gene involved in antibiotic resistance and/or cell survival. Such engineered bacteriophages as disclosed herein are termed “inhibitor-engineered bacteriophages” as they comprise a nucleic acid which encodes at least one inhibitor genes, such as but not limited to antibiotic resistance genes such as, but not limited to cat, vanA or mecD, or cell survival repair gene such as, but not limited to RecA, RecB, RecC, Spot or RelA. Naturally, one can engineer a bacteriophage to comprise at least one nucleic acid which encodes more than one inhibitor, for example, two or more inhibitors to the same gene or to at least two different genes which can be used in the methods and compositions as disclosed herein.

As used herein, the term “repressor-engineered bacteriophage” refers to bacteriophages that have been genetically engineered to comprise at least one nucleic acid which encodes a repressor protein, or fragment thereof, where the repressor protein function to prevent activation of a gene involved in a SOS response. Alternatively, the term repressor-engineered bacteriophage refers to a bacteriophage which has been genetically engineered to comprise at least one nucleic acid which encodes a repressor protein, such as an inhibitors (including but not limited to RNAi agents) which inhibits a non-SOS bacterial defense. Such engineered bacteriophages as disclosed herein are referred to herein as “repressor-engineered bacteriophages” as they comprise a nucleic acid encoding a repressor protein, for example, but not limited to, lexA, or soxR, or modified version thereof. In some embodiments, a SOS response gene is, for example but is not limited to marRAB, arcAB and lexO. One can engineer a repressor-engineered bacteriophage to comprise at least one nucleic acid which encodes more than one repressor, for example at least 2, 3, 4 or more repressors to the same or different SOS response gene, in any combination, can be used in the methods and compositions as disclosed herein. Similarly, one can also engineer a repressor-engineered bacteriophage to comprise at least one nucleic acid which encodes more than one repressor, for example at least 2, 3, 4 or more repressors, such as inhibitors which inhibits any number and any combination of non-SOS bacterial defense genes listed in Table 2, and can be used in any combination, can be used in the methods and compositions as disclosed herein. The term “repressor-engineered bacteriophage” also encompasses susceptibility-engineered bacteriophages as that term is defined herein.

As used herein, the term “susceptibility-engineered bacteriophage” refers to a bacteriophage that has been genetically engineered to comprise at least one nucleic acid which encodes at least one agent which increases the susceptibility of a bacterial cell to an antimicrobial agent. An agent which increases the susceptibility of a bacteria to an antimicrobial agent is referred to herein as a “susceptibility agent” and includes any agent (such as a protein or RNAi agent) which increases the bacteria's susceptibility to the antimicrobial agent by at least about 10% or at least about 15%, or at least about 20% or at least about 30% or at least about 50% or more than 50%, or any integer between 10% and 50% or more, as compared to the use of the antimicrobial agent alone. In one embodiment, a susceptibility agent is an agent which specifically targets a bacteria cell. In another embodiment, a susceptibility agent modifies (i.e. inhibits or activates) a pathway which is specifically expressed in bacterial cells. In one embodiment, a susceptibility agent is an agent which has an additive effect of the efficacy of the antimicrobial agent (i.e. the agent has an additive effect of the killing efficacy or inhibition of growth by the antimicrobial agent). In a preferred embodiment, a susceptibility agent is an agent which has a synergistic effect on the efficacy of the antimicrobial agent (i.e. the agent has a synergistic effect of the killing efficacy or inhibition of growth by the antimicrobial agent).

The term “engineered bacteriophage” as used herein refer to any one, or a combination of an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage as these phrases are defined herein.

The term “additive” when used in reference to a susceptibility agent, or an engineered bacteriophage such as an susceptibility-bacteriophage having an additive effect of the efficacy of the antimicrobial agent refers to refers to a total increase in antimicrobial efficacy (i e killing, or reducing the viability of a bacterial population or inhibiting growth of a bacterial population) with the combination of the antimicrobial agent and the susceptibility-engineered bacteriophage components of the invention, over their single efficacy of each component alone. An additive effect to increase total antimicrobial effectiveness can be a result of an increase in antimicrobial effect of both components (i.e. the antimicrobial agent and the susceptibility-engineered bacteriophage) or alternatively, it can be the result of the increase in activity of only one of the components (i.e. the antimicrobial agent or the susceptibility-engineered bacteriophage). For clarification by way of a non-limiting illustrative example of a additive effect, if an antimicrobial agent is effective at reducing a bacterial population by 30%, and a susceptibility-engineered bacteriophage was effective at reducing a bacterial population by 20%, an additive effect of a combination of the antimicrobial agent and the susceptibility-engineered bacteriophage could be, for example 35%. Stated another way, in this example, any total effect greater than 30% (i.e. greater than the highest antimicrobial efficacy (i.e. 30% which, in this example is displayed by the antimicrobial agent) would be indicative of an additive effect. In some embodiments of the present invention, the antimicrobial agent and susceptibility-engineered bacteriophage component show at least some additive anti-pathogenic activity. An additive effect of the combination of an antimicrobial agent with an engineered bacteriophage can be an increase in at least about 10% or at least about 20% or at least about 30% or at least about 40% or at least about 50% or more anti-pathogenic (or antimicrobial) efficacy as compared to the highest antimicrobial effect achieved with either the antimicrobial agent alone or the engineered bacteriophage alone.

The term “synergy” or “synergistically” are used interchangeably herein, and when used in reference to a susceptibility agent, or an engineered bacteriophage such as an susceptibility-bacteriophage having a synergistic effect of the efficacy of the antimicrobial agent refers to a total increase in antimicrobial efficacy (i e killing, or reducing the viability of a bacterial population or inhibiting growth of a bacterial population) with the combination of the antimicrobial agent and the susceptibility-engineered bacteriophage components of the invention, over their single and/or additive efficacy of each component alone. A synergistic effect to increase total antimicrobial effectiveness can be a result of an increase in antimicrobial effect of both components (i.e. the antimicrobial agent and the susceptibility-engineered bacteriophage) or alternatively, it can be the result of the increase in activity of only one of the components (i.e. the antimicrobial agent or the susceptibility-engineered bacteriophage). For clarification by way of a non-limiting illustrative example of a synergistic effect, if an antimicrobial agent is effective at reducing (i e killing) a bacterial population by 15%, and a susceptibility-engineered bacteriophage was effective at reducing a bacterial population by 10%, a synergistic effect of a combination of the antimicrobial agent and the susceptibility-engineered bacteriophage could be 50%. Stated another way, in this example, any total effect greater than 25% (i.e. greater than the sum of the antibacterial agent alone (i.e. 15%) and the susceptibility agent alone (i.e. 10%) would be indicative of a synergistic effect. In some embodiments of the present invention, the antimicrobial agent and susceptibility-engineered bacteriophage component show at least some synergistic anti-pathogenic activity. A synergistic effect of the combination of an antimicrobial agent with an engineered bacteriophage can be an increase in at least about 10% or at least about 20% or at least about 30% or at least about 40% or at least about 50% or more anti-pathogenic (or antimicrobial) efficacy as compared to the sum of the antimicrobial effect achieved with use of the antimicrobial agent alone or the engineered bacteriophage alone.

The term “bidirectional synergy” refers to the increase in activity of each component (i.e. the antimicrobial agent and the engineered bacteriophage) when used in combination with each other, and not merely an increase in activity of one of the antimicrobial components. In some embodiments, an antimicrobial agent and engineered bacteriophage show at least synergistic antimicrobial activity. In some embodiments, an antimicrobial agent and engineered bacteriophage show bidirectional synergistic antimicrobial activity. Stated in other words, for example, bidirectional synergy means an engineered bacteriophage enhances the activity of an antimicrobial agent and vice versa, an antimicrobial agent can be used to enhance the activity of the engineered bacteriophage.

The term “SOS” used in the context of “SOS response” or “SOS response genes” as used herein refers to an inducible DNA repair system that allows bacteria to survive sudden increases in DNA damage. SOS response genes are repressed to differ rent degrees under normal growth conditions. Without being bound by theory, the SOS response is a postreplication DNA repair system that allows DNA replication to bypass lesions or errors in the DNA. One example is the SOS repressor RecA protein. The RecA protein, stimulated by single-stranded DNA, is involved in the inactivation of the LexA repressor thereby inducing the response. The bacterial SOS response, studied extensively in Escherichia coli, is a global response to DNA damage in which the cell cycle is arrested and DNA repair and mutagenesis are induced. SOS is the prototypic cell cycle check-point control and DNA repair system. A central part of the SOS response is the de-repression of more than 20 genes under the direct and indirect transcriptional control of the LexA repressor. The LexA regulon includes recombination and repair genes recA, recN, and ruvAB, nucleotide excision repair genes uvrAB and uvrD, the error-prone DNA polymerase (pol) genes dinB (encoding pol IV) and umuDC (encoding pol V), and DNA polymerase II in addition to many other genes functions. In the absence of a functional SOS response (i.e. in the presence of repressors as disclosed herein), cells are sensitive to DNA damaging agents. McKenzie et al., PNAS, 2000; 6646-6651; Michel, PLos Biology, 2005; 3; e255, and which are incorporated in their entirety herein by reference. A “non-SOS gene” also includes a “bacterial defense gene” and refers to genes expressed by a bacteria or a microorganism which serve protect the bacteria or microorganism from cell death, for example from being killed or growth suppressed by an antimicrobial agent. Typically, inhibition or knocking out such non-SOS defense genes increases the susceptibility of a microorganism such as bacteria to an antimicrobial agent. A non-SOS gene” or “bacterial defense gene” is not part of the SOS-response network, but still serve as protective functions to prevent microorganism cell death. In certain conditions, some non-SOS genes and/or bacterial defense genes can be expressed (i.e. upregulated) on DNA damage or in stressful conditions. Examples of a non-SOS gene is soxS, which is repressed by soxR, and examples of defense genes are any gene listed in Table 2.

The term “repressor” as used herein, refers to a protein that binds to an operator of a gene preventing the transcription of the gene. Accordingly, a repressor can effectively “suppress” or inhibit the transcription of a gene. The binding affinity of repressors for the operator can be affected by other molecules, such as inducers, which bind to repressors and decrease their binding to the operator, while co-repressors increase the binding. The paradigm of repressor proteins is the lactose repressor protein that acts on the lac operon and for which the inducers are β-galactosides such as lactose, it is a polypeptide of 360 amino acids that is active as a tetramer. Other examples are the lambda repressor protein of lambda bacteriophage that prevents the transcription of the genes required for the lytic cycle leading to lysogeny and the cro protein, also of lambda, which represses the transcription of the lambda repressor protein establishing the lytic cycle. Both of these are active as dimers and have a common structural feature the helix turn helix motif that is thought to bind to DNA with the helices fitting into adjacent major grooves. Useful repressors according to the present invention include, but are not limited to lexA, marR, arc, soxR, fur, crp, icdA, or craA or modified version thereof.

The term “antimicrobial agent” as used herein refers to any entity with antimicrobial activity, i.e. the ability to inhibit the growth and/or kill bacterium, for example gram positive- and gram negative bacteria. An antimicrobial agent is any agent which results in inhibition of growth or reduction of viability of a bacteria by at least about 30% or at least about 40%, or at least about 50% or at least about 60% or at least about 70% or more than 70%, or any integer between 30% and 70% or more, as compared to in the absence of the antimicrobial agent. Stated another way, an antimicrobial agent is any agent which reduces a population of antimicrobial cells, such as bacteria by at least about 30% or at least about 40%, or at least about 50% or at least about 60% or at least about 70% or more than 70%, or any integer between 30% and 70% as compared to in the absence of the antimicrobial agent. In one embodiment, an antimicrobial agent is an agent which specifically targets a bacteria cell. In another embodiment, an antimicrobial agent modifies (i.e. inhibits or activates or increases) a pathway which is specifically expressed in bacterial cells. In some embodiments, an antimicrobial agent does not include the following agents; chemotherapeutic agent, a toxin protein expressed by a bacteria or other microorganism (i.e. a bacterial toxin protein) and the like. An antimicrobial agent can include any chemical, peptide (i.e. an antimicrobial peptide), peptidomimetic, entity or moiety, or analogues of hybrids thereof, including without limitation synthetic and naturally occurring non-proteinaceous entities. In some embodiments, an antimicrobial agent is a small molecule having a chemical moiety. For example, chemical moieties include unsubstituted or substituted alkyl, aromatic or heterocyclyl moieties including macrolides, leptomycins and related natural products or analogues thereof. Antimicrobial agents can be any entity known to have a desired activity and/or property, or can be selected from a library of diverse compounds.

The term “agent” as used herein and throughout the application is intended to refer to any means such as an organic or inorganic molecule, including modified and unmodified nucleic acids such as antisense nucleic acids, RNAi, such as siRNA or shRNA, peptides, peptidomimetics, receptors, ligands, and antibodies, aptamers, polypeptides, nucleic acid analogues or variants thereof.

The term “antimicrobial peptide” as used herein refers to any peptides with antimicrobial activity, i.e. the ability to inhibit the growth and/or kill bacterium, for example gram positive- and gram negative bacteria. The term antimicrobial peptides encompasses all peptides that have antimicrobial activity, and are typically, for example but not limited to, short proteins, generally between 12 and 50 amino acids long, however larger proteins with such as, for example lysozymes are also encompassed as antimicrobial peptides in the present invention. Also included in the term antimicrobial peptide are antimicrobial peptidomimetics, and analogues or fragments thereof. The term “antimicrobial peptide” also includes all cyclic and non-cyclic antimicrobial peptides, or derivatives or variants thereof, including tautomers, see Li et al. JACS, 2006, 128: 5776-85 and world-wide-web at //aps.unmc.edu, at /AP/main.php for examples, which are incorporated herein in their entirety by reference. In some embodiments, the antimicrobial peptide is a lipopeptide, and in some embodiments the lipopeptide is a cyclic lipopeptide. The lipopeptides include, for example but not limited to, the polymyxin class of antimicrobial peptides.

The term “microorganism” includes any microscopic organism or taxonomically related macroscopic organism within the categories algae, bacteria, fungi, yeast and protozoa or the like. It includes susceptible and resistant microorganisms, as well as recombinant microorganisms. Examples of infections produced by such microorganisms are provided herein. In one aspect of the invention, the antimicrobial agents and enhancers thereof are used to target microorganisms in order to prevent and/or inhibit their growth, and/or for their use in the treatment and/or prophylaxis of an infection caused by the microorganism, for example multi-drug resistant microorganisms and gram-negative microorganisms. In some embodiments, gram-negative microorganisms are also targeted.

The anti-pathogenic aspects of the invention target the broader class of “microorganism” as defined herein. However, given that a multi-drug resistant microorganism is so difficult to treat, the antimicrobial agent and inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophage in the context of the anti-pathogenic aspect of the invention is suited to treating all microorganisms, including for example multi-drug resistant microorganisms, such as bacterium and multi-drug resistant bacteria.

Unless stated otherwise, in the context of this specification, the use of the term “microorganism” alone is not limited to “multi-drug resistant organism”, and encompasses both drug-susceptible and drug-resistant microorganisms. The term “multi-drug resistant microorganism” refers to those organisms that are, at the very least, resistant to more than two antimicrobial agents such as antibiotics in different antibiotic classes. This includes those microorganisms that have more resistance than those that are resistant to three or more antibiotics in a single antibiotic class. This also includes microorganisms that are resistant to a wider range of antibiotics, i.e. microorganisms that are resistant to one or more classes of antibiotics.

The term “persistent cell” or “persisters” are used interchangeably herein and refer to a metabolically dormant subpopulation of microorganisms, typically bacteria, which are not sensitive to antimicrobial agents such as antibiotics. Persisters typically are not responsive (i.e. are not killed by the antibiotics) as they have non-lethally downregulated the pathways on which the antimicrobial agents act i.e. the persister cells have down regulated the pathways which are normally inhibited or corrupted by the antimicrobial agents, such as the transcription, translation, DNA replication and cell wall biosynthesis pathways. Persisters can develop at non-lethal (or sub-lethal) concentrations of the antimicrobial agent.

The term “analog” as used herein refers to a composition that retains the same structure or function (e.g., binding to a receptor) as a polypeptide or nucleic acid herein. Examples of analogs include peptidomimetics, peptide nucleic acids, small and large organic or inorganic compounds, as well as derivatives and variants of a polypeptide or nucleic acid herein. The term “analog” as used herein refers to a composition that retains the same structure or function (e.g., binding to a receptor) as a polypeptide or nucleic acid herein.

The term “infection” or “microbial infection” which are used interchangeably herein refers to in its broadest sense, any infection caused by a microorganism and includes bacterial infections, fungal infections, yeast infections and protozomal infections.

The term “treatment and/prophylaxis” refers generally to afflicting a subject, tissue or cell to obtain a desired pharmacologic arid/or physiologic effect, which in the case of the methods of this invention, include reduction or elimination of microbial infections or prevention of microbial infections. The methods as disclosed herein can be used prophylactically for example in instances where an individual is susceptible for infections or re-infection with a particular bacterial strain or a combination of such strains. For example, microbial infections such as bacterial infections such as biofilms can occur on any surface where sufficient moisture and nutrients are present. One such surface is the surface of implanted medical devices, such as catheters, heart valves and joint replacements. In particular, catheters are associated with infection by many biofilm forming organisms such as Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa, Enterococcus faecalis and Candida albicans which frequently result in generalized blood stream infection. In a subject identified to have a catheter infected with bacterial, such as for example, a bacterial infected central venous catheter (CVC), the subject can have the infected catheter removed and can be treated by the methods and compositions as disclosed herein comprising an engineered bacteriophage and antimicrobial agent to eliminate the bacterial infection. Furthermore, on removal of the infected catheter and its replacement with a new catheter, the subject can also be administered the compositions comprising engineered bacteriophages and antimicrobial agents as disclosed herein on a prophylaxis basis to prevent re-infection or the re-occurrence of the bacterial infection. Alternatively, a subject can be administered the compositions as disclosed herein comprising engineered bacteriophages and antimicrobial agents on a prophylaxis basis on initial placement of the catheter to prevent any antimicrobial infection such as a bacterial biofilm infection. The effect can be prophylactic in terms of completely or partially preventing a disease or sign or symptom thereof, and/or can be therapeutic in terms of a partial or complete cure of a disease.

As used herein, the term “effective amount” is meant an amount of antimicrobial agent and/or inhibitor-engineered bacteriophages or repressor-engineered bacteriophages effective to yield a desired decrease in bacteria or increase to increase the efficacy of antimicrobial agent as compared to the activity of the antimicrobial agent alone (i.e. without the engineered bacteriophages as disclosed herein). The term “effective amount” as used herein refers to that amount of composition necessary to achieve the indicated effect, i.e. a reduction of the number of viable microorganisms, such as bacteria, by at reduction of least 5%, at least 10%, by at least 20%, by at least 30% . . . at least 35%, . . . at least 50%, . . . at least 60%, . . . at least 90% or any reduction of viable microorganism in between. As used herein, the effective amount of the bacteriophage as disclosed herein is the amount sufficient to enhance the effect of the antimicrobial agents by at least . . . 5%, at least 10%, . . . at least 15%, . . . at least 20%, . . . at least 25%, . . . at least 35%, . . . at least 50%, . . . at least 60%, . . . at least 90% and all amounts in-between as compared to use of the antimicrobial agent alone. Or alternatively result in the same efficacy of the antimicrobial effect with less (i.e. for example by about 10%, or about 15%, . . . or about 20%, . . . or about 25%, . . . or about 35%, . . . or about 50%, . . . or about 60%, . . . or more than 60% less) amount or dose of the antimicrobial agents as compared to its use alone to achieve the same efficacy of antimicrobial effect. The “effective amount” or “effective dose” will, obviously, vary with such factors, in particular, the strain of bacteria being treated, the strain of bacteriophage being used, the genetic modification of the bacteriophage being used, the antimicrobial agent, as well as the particular condition being treated, the physical condition of the subject, the type of subject being treated, the duration of the treatment, the route of administration, the type of antimicrobial agent and/or enhancer of antimicrobial agent, the nature of concurrent therapy (if any), and the specific formulations employed, the ratio of the antimicrobial agent and/or enhancers antimicrobial agent components to each other, the structure of each of these components or their derivatives. The term “effective amount” when used in reference to administration of the compositions comprising an antimicrobial agent and a engineered bacteriophage as disclosed herein to a subject refers to the amount of the compositions—to reduce or stop at least one symptom of the disease or disorder, for example a symptom or disorder of the microorganism infection, such as bacterial infection. For example, an effective amount using the methods as disclosed herein would be considered as the amount sufficient to reduce a symptom of the disease or disorder of the bacterial infection by at least 10%. An effective amount as used herein would also include an amount sufficient to prevent or delay the development of a symptom of the disease, alter the course of a symptom disease (for example but not limited to, slow the progression of a symptom of the disease), or reverse a symptom of the disease.

As used herein, a “pharmaceutical carrier” is a pharmaceutically acceptable solvent, suspending agent or vehicle for delivering the combination of antimicrobial agent and/or inhibitor-engineered bacteriophages or repressor-engineered bacteriophages to the surface infected with bacteria or to a subject. The carrier can be liquid or solid and is selected with the planned manner of administration in mind. Each carrier must be pharmaceutically “acceptable” in the sense of being compatible with other ingredients of the composition and non injurious to the subject.

As used herein, “gene silencing” or “gene silenced” in reference to an activity of in RNAi molecule, for example a siRNA or miRNA refers to a decrease in the mRNA level in a cell for a target gene by at least about 5%, about 10%, about 20%, about 30%, about 40%, about 50%, about 60%, about 70%, about 80%, about 90%, about 95%, about 99%, about 100% of the mRNA level found in the cell without the presence of the miRNA or RNA interference molecule. In one preferred embodiment, the mRNA levels are decreased by at least about 70%, about 80%, about 90%, about 95%, about 99%, about 100%.

As used herein, the term “RNAi” refers to any type of interfering RNA, including but not limited to, siRNAi, shRNAi, endogenous microRNA and artificial microRNA. For instance, it includes sequences previously identified as siRNA, regardless of the mechanism of down-stream processing of the RNA (i.e. although siRNAs are believed to have a specific method of in vivo processing resulting in the cleavage of mRNA, such sequences can be incorporated into the vectors in the context of the flanking sequences described herein).

As used herein an “siRNA” refers to a nucleic acid that forms a double stranded RNA, which double stranded RNA has the ability to reduce or inhibit expression of a gene or target gene when the siRNA is present or expressed in the same cell as the target gene, for example Lp-PLA₂. The double stranded RNA siRNA can be formed by the complementary strands. In one embodiment, a siRNA refers to a nucleic acid that can form a double stranded siRNA. The sequence of the siRNA can correspond to the full length target gene, or a subsequence thereof. Typically, the siRNA is at least about 15-50 nucleotides in length (e.g., each complementary sequence of the double stranded siRNA is about 15-50 nucleotides in length, and the double stranded siRNA is about 15-50 base pairs in length, preferably about 19-30 base nucleotides, preferably about 20-25 nucleotides in length, e.g., 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, or 30 nucleotides in length).

As used herein “shRNA” or “small hairpin RNA” (also called stem loop) is a type of siRNA. In one embodiment, these shRNAs are composed of a short, e.g. about 19 to about 25 nucleotide, antisense strand, followed by a nucleotide loop of about 5 to about 9 nucleotides, and the analogous sense strand. Alternatively, the sense strand can precede the nucleotide loop structure and the antisense strand can follow.

The terms “microRNA” or “miRNA” are used interchangeably herein are endogenous RNAs, some of which are known to regulate the expression of protein-coding genes at the posttranscriptional level. Endogenous microRNA are small RNAs naturally present in the genome which are capable of modulating the productive utilization of mRNA. The term artificial microRNA includes any type of RNA sequence, other than endogenous microRNA, which is capable of modulating the productive utilization of mRNA. MicroRNA sequences have been described in publications such as Lim, et al., Genes & Development, 17, p. 991-1008 (2003), Lim et al Science 299, 1540 (2003), Lee and Ambros Science, 294, 862 (2001), Lau et al., Science 294, 858-861 (2001), Lagos-Quintana et al, Current Biology, 12, 735-739 (2002), Lagos Quintana et al, Science 294, 853-857 (2001), and Lagos-Quintana et al, RNA, 9, 175-179 (2003), which are incorporated by reference. Multiple microRNAs can also be incorporated into a precursor molecule. Furthermore, miRNA-like stem-loops can be expressed in cells as a vehicle to deliver artificial miRNAs and short interfering RNAs (siRNAs) for the purpose of modulating the expression of endogenous genes through the miRNA and or RNAi pathways.

As used herein, “double stranded RNA” or “dsRNA” refers to RNA molecules that are comprised of two strands. Double-stranded molecules include those comprised of a single RNA molecule that doubles back on itself to form a two-stranded structure. For example, the stem loop structure of the progenitor molecules from which the single-stranded miRNA is derived, called the pre-miRNA (Bartel et al. 2004. Cell 116:281-297), comprises a dsRNA molecule.

The terms “patient”, “subject” and “individual” are used interchangeably herein, and refer to an animal, particularly a human, to whom treatment including prophylaxis treatment is provided. The term “subject” as used herein refers to human and non-human animals. The term “non-human animals” and “non-human mammals” are used interchangeably herein includes all vertebrates, e.g., mammals, such as non-human primates, (particularly higher primates), sheep, dog, rodent (e.g. mouse or rat), guinea pig, goat, pig, cat, rabbits, cows, and non-mammals such as chickens, amphibians, reptiles etc. In one embodiment, the subject is human. In another embodiment, the subject is an experimental animal or animal substitute as a disease model. Suitable mammals also include members of the orders Primates, Rodentla, Lagomorpha, Cetacea, Homo sapiens, Carnivora, Perissodactyla and Artiodactyla. Members of the orders Perissodactyla and Artiodactyla are included in the invention because of their similar biology and economic importance, for example but not limited to many of the economically important and commercially important animals such as goats, sheep, cattle and pigs have very similar biology and share high degrees of genomic homology.

The term “gene” used herein can be a genomic gene comprising transcriptional and/or translational regulatory sequences and/or a coding region and/or non-translated sequences (e.g., introns, 5′- and 3′-untranslated sequences and regulatory sequences). The coding region of a gene can be a nucleotide sequence coding for an amino acid sequence or a functional RNA, such as tRNA, rRNA, catalytic RNA, siRNA, miRNA and antisense RNA. A gene can also be an mRNA or cDNA corresponding to the coding regions (e.g. exons and miRNA) optionally comprising 5′- or 3′ untranslated sequences linked thereto. A gene can also be an amplified nucleic acid molecule produced in vitro comprising all or a part of the coding region and/or 5′- or 3′-untranslated sequences linked thereto.

The term “gene product(s)” as used herein refers to include RNA transcribed from a gene, or a polypeptide encoded by a gene or translated from RNA.

The term “inhibit” or “reduced” or “reduce” or “decrease” as used herein generally means to inhibit or decrease the expression of a gene or the biological function of the protein (i.e. an antibiotic resistance protein) by a statistically significant amount relative to in the absence of an inhibitor. The term “inhibition” or “inhibit” or “reduce” when referring to the activity of an antimicrobial agent or composition as disclosed herein refers to prevention of, or reduction in the rate of growth of the bacteria. Inhibition and/or inhibit when used in the context to refer to an agent that inhibits an antibiotic resistance gene and/or cell survival refers to the prevention or reduction of activity of a gene or gene product, that when inactivated potentiates the activity of an antimicrobial agent. However, for avoidance of doubt, “inhibit” means statistically significant decrease in activity of the biological function of a protein by at least about 10% as compared to in the absence of an inhibitor, for example a decrease by at least about 20%, at least about 30%, at least about 40%, at least about 50%, or least about 60%, or least about 70%, or least about 80%, at least about 90% or more, up to and including a 100% inhibition (i.e. complete absence of an antibiotic resistance gene protein in the presence of an inhibitor), or any decrease in biological activity of the protein (i.e. of an antibiotic resistance gene protein) between 10-100% as compared to a in the absence of an inhibitor.

The terms “activate” or “increased” or “increase” as used in the context of biological activity of a protein (i.e. activation of a SOS response gene) herein generally means an increase in the biological function of the protein (i.e. SOS response protein) by a statically significant amount relative to in a control condition. For the avoidance of doubt, an “increase” of activity, or “activation” of a protein means a statistically significant increase of at least about 10% as compared to the absence of an agonist or activator agent, including an increase of at least about 20%, at least about 30%, at least about 40%, at least about 50%, at least about 60%, at least about 70%, at least about 80%, at least about 90%, at least about 100% or more, including, for example at least 2-fold, at least 3-fold, at least 4-fold, at least 5-fold, at least 10-fold increase or greater as compared to in a control condition.

The term “nucleic acid” or “oligonucleotide” or “polynucleotide” used herein can mean at least two nucleotides covalently linked together. As will be appreciated by those in the art, the depiction of a single strand also defines the sequence of the complementary strand. Thus, a nucleic acid also encompasses the complementary strand of a depicted single strand. As will also be appreciated by those in the art, many variants of a nucleic acid can be used for the same purpose as a given nucleic acid. Thus, a nucleic acid also encompasses substantially identical nucleic acids and complements thereof. As will also be appreciated by those in the art, a single strand provides a probe for a probe that can hybridize to the target sequence under stringent hybridization conditions. Thus, a nucleic acid also encompasses a probe that hybridizes under stringent hybridization conditions.

Nucleic acids can be single stranded or double stranded, or can contain portions of both double stranded and single stranded sequence. The nucleic acid can be DNA, both genomic and cDNA, RNA, or a hybrid, where the nucleic acid can contain combinations of deoxyribo- and ribo-nucleotides, and combinations of bases including uracil, adenine, thymine, cytosine, guanine, inosine, xanthine hypoxanthine, isocytosine and isoguanine. Nucleic acids can be obtained by chemical synthesis methods or by recombinant methods.

A nucleic acid will generally contain phosphodiester bonds, although nucleic acid analogs can be included that can have at least one different linkage, e.g., phosphoramidate, phosphorothioate, phosphorodithioate, or O-methylphosphoroamidite linkages and peptide nucleic acid backbones and linkages. Other analog nucleic acids include those with positive backbones; non-ionic backbones, and non-ribose backbones, including those described in U.S. Pat. Nos. 5,235,033 and 5,034,506, which are incorporated by reference. Nucleic acids containing one or more non-naturally occurring or modified nucleotides are also included within one definition of nucleic acids. The modified nucleotide analog can be located for example at the 5′-end and/or the 3′-end of the nucleic acid molecule. Representative examples of nucleotide analogs can be selected from sugar- or backbone-modified ribonucleotides. It should be noted, however, that also nucleobase-modified ribonucleotides, i.e. ribonucleotides, containing a non naturally occurring nucleobase instead of a naturally occurring nucleobase such as uridines or cytidines modified at the 5-position, e.g. 5-(2-amino)propyl uridine, 5-bromo uridine; adenosines and guanosines modified at the 8-position, e.g. 8-bromo guanosine; deaza nucleotides, e.g. 7 deaza-adenosine; O- and N-alkylated nucleotides, e.g. N6-methyl adenosine are suitable. The 2′OH-group can be replaced by a group selected from H. OR, R. halo, SH, SR, NH₂, NHR, NR₂ or CN, wherein R is C-C6 alkyl, alkenyl or alkynyl and halo is F, Cl, Br or I. Modifications of the ribose-phosphate backbone can be done for a variety of reasons, e.g., to increase the stability and half-life of such molecules in physiological environments or as probes on a biochip. Mixtures of naturally occurring nucleic acids and analogs can be made; alternatively, mixtures of different nucleic acid analogs, and mixtures of naturally occurring nucleic acids and analogs can be made.

As used herein, the terms “administering,” and “introducing” are used interchangeably and refer to the placement of the bacteriophages and/or antimicrobial agents as disclosed herein onto the surface colonized by bacteria or into a subject, such as a subject with a bacterial infection or other microorganism infection, by any method or route which results in at least partial localization of the engineered-bacteriophages and/or antimicrobial agents at a desired site. The compositions as disclosed herein can be administered by any appropriate route which results in the effective killing, elimination or control of the growth of the bacteria.

The term “vectors” is used interchangeably with “plasmid” to refer to a nucleic acid molecule capable of transporting another nucleic acid to which it has been linked A vector can be a plasmid, bacteriophage, bacterial artificial chromosome or yeast artificial chromosome. A vector can be a DNA or RNA vector. A vector can be either a self replicating extrachromosomal vector or a vector which integrate into a host genome. Vectors capable of directing the expression of genes and/or nucleic acid sequence to which they are operatively linked are referred to herein as “expression vectors”. In general, expression vectors of utility in recombinant DNA techniques are often in the form of “plasmids” which refer to circular double stranded DNA loops which, in their vector form are not bound to the chromosome. Other expression vectors can be used in different embodiments of the invention, for example, but are not limited to, plasmids, episomes, bacteriophages or viral vectors, and such vectors can integrate into the host's genome or replicate autonomously in the particular cell. Other forms of expression vectors known by those skilled in the art which serve the equivalent functions can also be used. Expression vectors comprise expression vectors for stable or transient expression encoding the DNA.

The term “analog” as used herein refers to a composition that retains the same structure or function (e.g., binding to a receptor) as a polypeptide or nucleic acid herein. Examples of analogs include peptidomimetics, peptide nucleic acids, small and large organic or inorganic compounds, as well as derivatives and variants of a polypeptide or nucleic acid herein. The term “analog” as used herein refers to a composition that retains the same structure or function (e.g., binding to a receptor) as a polypeptide or nucleic acid herein.

The term “derivative” or “variant” as used herein refers to a peptide, chemical or nucleic acid that differs from the naturally occurring polypeptide or nucleic acid by one or more amino acid or nucleic acid deletions, additions, substitutions or side-chain modifications. Amino acid substitutions include alterations in which an amino acid is replaced with a different naturally-occurring or a non-conventional amino acid residue. Such substitutions may be classified as “conservative”, in which case an amino acid residue contained in a polypeptide is replaced with another naturally occurring amino acid of similar character either in relation to polarity, side chain functionality or size.

Substitutions encompassed by the present invention may also be “non conservative”, in which an amino acid residue which is present in a peptide is substituted with an amino acid having different properties, such as naturally-occurring amino acid from a different group (e.g., substituting a charged or hydrophobic amino; acid with alanine), or alternatively, in which a naturally-occurring amino acid is substituted with a non-conventional amino acid. In some embodiments amino acid substitutions are conservative.

The articles “a” and “an” are used herein to refer to one or to more than one (i.e., at least one) of the grammatical object of the article. By way of example, “an element” means one element or more than one element. Thus, in this specification and the appended claims, the singular forms “a,” “an,” and “the” include plural references unless the context clearly dictates otherwise. Thus, for example, reference to a pharmaceutical composition comprising “an agent” includes reference to two or more agents.

As used herein, the term “comprising” means that other elements can also be present in addition to the defined elements presented. The use of “comprising” indicates inclusion rather than limitation. The term “consisting of” refers to compositions, methods, and respective components thereof as described herein, which are exclusive of any element not recited in that description of the embodiment. As used herein the term “consisting essentially of” refers to those elements required for a given embodiment. The term permits the presence of elements that do not materially affect the basic and novel or functional characteristic(s) of that embodiment of the invention.

Other than in the operating examples, or where otherwise indicated, all numbers expressing quantities of ingredients or reaction conditions used herein should be understood as modified in all instances by the term “about.” The term “about” when used in connection with percentages can mean±1%.

This invention is further illustrated by the following examples which should not be construed as limiting. The contents of all references cited throughout this application, as well as the figures and tables are incorporated herein by reference.

It should be understood that this invention is not limited to the particular methodology, protocols, and reagents, etc., described herein and as such can vary. The terminology used herein is for the purpose of describing particular embodiments only, and is not intended to limit the scope of the present invention, which is defined solely by the claims. Other features and advantages of the invention will be apparent from the following Detailed Description, the drawings, and the claims.

Inhibitor-Engineered Bacteriophages

One aspect of the present invention relates to an engineered bacteriophage which comprise a nucleic acid which encodes an agent which inhibits at least one antibiotic resistance gene or at least one cell survival gene, thereby gene silencing such genes and preventing the development of antibiotic resistance and/or increased cell viability of the bacteria in the presence of the antimicrobial agent. As discussed herein, such engineered bacteriophages which comprise a nucleic acid encoding an agent which inhibits at least one gene involved in antibiotic resistance and/or at least one cell survival gene as disclosed herein are referred to herein as “inhibitor-engineered bacteriophages”.

In some embodiments, an inhibitor-engineered bacteriophage can comprise a nucleic acid encoding any type of inhibitor, such as a nucleic acid inhibitor. Nucleic acid inhibitors include, for example but are not limited to antisense nucleic acid inhibitors, oligonucleosides, RNA interference (RNAi) and paired termini (PT) antisense and variants thereof.

In some embodiments of this aspect of the invention, an inhibitor-engineered bacteriophage can encode an agent which inhibits the gene expression and/or protein function of any bacterial antibiotic resistance genes commonly known by persons of ordinary skill in the art, such as, but not limited to cat (SEQ ID NO:1), vanA (SEQ ID NO:2) or mecD (SEQ ID NO:3). In alternative embodiments, an agent can inhibit the gene expression and/or protein function of any bacterial cell survival repair gene commonly known by persons of ordinary skill in the art such as, but not limited to RecA, RecB, RecC, Spot or RelA.

For reference, RecA (recombinase A) can be identified by Accession number: P03017 and Gene ID Seq ID GI:132224. Table 1 provides the accession numbers and Gene ID numbers for examples of antibiotic resistance genes and cell survival genes which can be inhibited in the methods of the present invention, as well examples of as repressors which one can use in repressor-engineered bacteriophages.

TABLE 1 Gene ID numbers and SEQ ID SEQ ID Gene NO: Other Aliases: Annotation Gene ID: Other Designations: ptsG 1 b1101, CR, NC_000913.2 945651 fused glucose-specific PTS (cat) ECK1087, (1157092 . . . 1158525) enzymes: IIB JW1087, car, cat, component/IIC component glcA, tgl, umg, umgC vanA 2 M97297 479085 Vancomycin-resistant protein mecA 3 X52593 46610 Penicillin binding protein II recA 4 b2699, NC_000913.2 947170 ECK2694, (2820730 . . . 2821791, JW2669, lexB, complement) recH, rnmB, srf, tif, umuB, umuR, zab recB 5 b2820, NC_000913.2 947286 exonuclease V (RecBCD ECK2816, (2950483 . . . 2954025, complex), beta subunit JW2788, ior, complement) rorA recC 6 b2822, NC_000913.2 947294 exonuclease V (RecBCD ECK2818, (2957082 . . . 2960450, complex), gamma chain JW2790 complement) spoT 7 b3650, NC_000913.2 948159 bifunctional (p)ppGpp ECK3640, (3820423 . . . 3822531) synthetase II/guanosine- JW3625 3′,5′-bis pyrophosphate 3′- pyrophosphohydrolase relA 8 b2784, NC_000913.2 947244 (p)ppGpp synthetase I/GTP ECK2778, (2909439 . . . 2911673, pyrophosphokinase JW2755, RC complement) lexA 9 b4043, NC_000913.2 948544 DNA-binding ECK4035, (4255138 . . . 4255746) transcriptional repressor of JW4003, exrA, SOS regulon recA, spr, tsl, umuA marR 10 b1530, NC_000913.2 945825 DNA-binding ECK1523, (1617144 . . . 1617578) transcriptional repressor of JW5248, cfxB, multiple antibiotic resistance inaR, soxQ arc 11 P22gp18 NC_002371.2 1262795 Arc; transcriptional (14793 . . . 15022) repressor soxR 12 b4063, NC_000913.2 948566 DNA-binding ECK4055, (4275492 . . . 4275956) transcriptional dual JW4024, marC regulator, Fe—S center for redox-sensing fur 13 b0683, NC_000913.2 945295 DNA-binding ECK0671, (709423 . . . 709869, transcriptional dual JW0669 complement) regulator of siderophore biosynthesis and transport crp 14 b3357, NC_000913.2 947867 DNA-binding ECK3345, (3484142 . . . 3484774) transcriptional dual JW5702, cap, regulator csm icd 15 b1136, NC_000913.2 945702 e14 prophage; isocitrate ECK1122, (1194346 . . . 1195596) dehydrogenase, specific for JW1122, icdA, NADP+ icdE csrA 16 b2696, NC_000913.2 947176 pleiotropic regulatory ECK2691, (2816983 . . . 2817168, protein for carbon source JW2666, zfiA complement) metabolism ompA 17 b0957, NC_000913.2 945571 outer membrane protein A ECK0948, (1018236 . . . 1019276, (3a; II*; G; d) JW0940, con, complement) tolG, tut

In some embodiments, one can use a modular design strategy in which bacteriophage kill bacteria in a species-specific manner are engineered to express at least one inhibitor of at least one antibiotic gene and/or a cell survival gene, or express at least one repressor of a SOS response gene. For example, in some embodiments, the bacteriophage can express an nucleic acid inhibitor, such as an antisense nucleic acid inhibitor or antisense RNA (asRNA) which inhibits at least one, or at least two or at least three antibiotic genes and/or a cell survival gene, such as, but not limited to cat (SEQ ID NO:1), vanA (SEQ ID NO:2) mecD (SEQ ID NO:3), RecA (SEQ ID NO:4), RecB (SEQ ID NO:5), RecC (SEQ ID NO:6), Spot (SEQ ID NO:7) or RelA (SEQ ID NO:8).

Some aspects of the present invention are directed to use of a inhibitor-engineered bacteriophage as an adjuvants to an antimicrobial agent, where an inhibitor-engineered bacteriophage encodes at least one inhibitor to an antimicrobial or antibacterial resistance gene in the bacteria. Previous uses of antibiotic resistance genes have been used to increase the susceptibility of bacteria to antimicrobial agents. For example, US patent application US2002/0076722 discusses a method of improving susceptibility of bacteria to antibacterial agents by identifying gene loci which decrease the bacterium's susceptibility to antibacterial agents, and identify OftX, WbbL, Slt, and Wza as such loci. However, in contrast to the present application, US2002/0076722 does not teach method to inhibit the loci to increase the bacterial susceptibility to antibacterial agents. Similarly, U.S. Pat. No. 7,125,622 discusses a method to identify bacterial antibiotic resistance genes by analyzing pools of bacterial genomic fragments and selecting those fragments which hybridize or have high homology (using computer assisted in silico methodologies) to numerous known bacterial resistance genes. The U.S. Pat. No. 7,125,622 discloses a number of bacterial resistance genes, including; katG, rpoB, rpsL, ampC, beta-lactamases, aminoglycoside kinases, mexA, mexB, oprM, ermA, carA, ImrA, ereA, vgbA, InvA, mphA, tetA, tetB, pp-cat, vanA, vanH, vanR, vanX, vanY, vanZ, folC, folE, folP, and folk, which are encompassed as targets for the inhibitors in an inhibitor-engineered bacteriophage as discussed herein. However, in contrast to the present application, U.S. Pat. No. 7,125,622 does not teach method to inhibit the bacterial resistance genes using an inhibitor-engineered bacteriophage of the present invention, or their inhibition by such an inhibitor-engineered bacteriophage in combination with an antimicrobial agent. Similarly, International Application WO2008/110840 discusses the use of six different bacteriophages (NCIMB numbers 41174-41179) to increase sensitivity of bacteria to antibiotics. However, WO2008/110840 but does not teach genetically modifying such bacteriophages to inhibit bacterial resistance genes or repressing SOS genes. While there are some reports of modifying bacteriophages to increase their effectiveness of killing bacteria, previous studies have mainly focused on optimizing method to degrade bacteria biofilms, such as, for example introducing a lysase enzyme such as alginate lyse (discussed in International Application WO04/062677); or modifying bacteriophages to inhibit the cell which propagates the bacteriophage, such introducing a KIL gene such as the Holin gene in the bacteriophage (discussed in International Application WO02/034892 and WO04/046319), or introducing bacterial toxin genes such as pGef or ChpBK and Toxin A (discussed in U.S. Pat. No. 6,759,229 and Westwater et al., Antimicrobial agents and Chemotherapy, 2003., 47: 1301-1307). However, unlike the present invention the modified bacteriophages discussed in WO04/062677, WO02/034892, WO04/046319, 6,759,229 and Westwater et al., have not been modified to target and disable the bacteria's antimicrobial resistance mechanism by inhibiting the bacterial resistance genes or expressing a repressor to a SOS gene.

An inhibitor to any antimicrobial resistance genes known to one or ordinary skill in the art is encompassed for use in the inhibitor-engineered bacteriophages disclosed herein. In addition to the antibiotic resistance genes discussed herein, other such antibiotic resistance genes which can be used include, for example, are katG, rpoB, rpsL, ampC, beta-lactamases, aminoglycoside kinases, mexA, mexB, oprM, ermA, carA, ImrA, ereA, vgbA, InvA, mphA, tetA, tetB, vanH, vanR, vanX, vanY, vanZ, folC, folE, folP, and folk which are disclosed in U.S. Pat. No. 7,125,622, which is incorporated herein in its entity by reference.

Repressor-Engineered Bacteriophages

In another aspect of the present invention, an engineered bacteriophage can comprise a nucleic acid encoding a repressor, or fragment thereof, of a SOS response gene or a non-SOS defense gene and as discussed previously, are referred to herein as “repressor-engineered bacteriophages.”

In some embodiments of this aspect and all aspects described herein, a repressor-engineered bacteriophage can comprises a nucleic acid encoding a repressor protein, or fragment thereof of a bacterial SOS response gene, or an agent (such as a protein) which inhibits a non-SOS pathway bacterial defense gene.

Without wishing to be limited to theory, the SOS response in bacteria is an inducible DNA repair system which allows bacteria to survive sudden increases in DNA damage. For instance, when bacteria are exposed to stress they produce can defense proteins from genes which are normally in a repressed state and allow repair of damaged DNA and reactivation of DNA synthesis. The SOS response is based upon the paradigm that bacteria play an active role in the mutation of their own genomes by inducing the production of proteins during stressful conditions which facilitate mutations, including Pol II (PolB), Pol IV (dinB) and Pol V (umuD and umuC). Inhibition of these proteins, such as Pol II, Pol IV and Pol V or prevention of their derepression by inhibition of LexA cleavage is one strategy to prevent the development of antibiotic-resistant bacteria. The SOS response is commonly triggered by single-stranded DNA, which accumulates as a result of either DNA damage or problematic replication or on bacteriophage infection. In some situations antibiotics trigger the SOS response, as some antibiotics, such as fluoroquinolones and β-lactams induce antibiotic-mediated DNA damage. The SOS response is discussed in Benedicte Michel, PLos Biology, 2005; 3; 1174-1176; Janion et al., Acta Biochemica Polonica, 2001; 48; 599-610 and Smith et al., 2007, 9; 549-555, and Cirz et al., PLoS Biology, 2005; 6; 1024-1033, and are incorporated herein in their entirety by reference.

In some embodiments, the repressor of an SOS response gene is, for example but not limited to, lexA (SEQ ID NO:9), or modified version thereof. In other embodiments of this aspect of the invention, a SOS response gene is, for example but is not limited to marRAB (SEQ ID NO:18), arcAB (SEQ ID NO:19) and lexO (SEQ ID NO:20).

In some embodiments of this aspect and all other aspects described herein, an inhibitor of a non-SOS pathway bacterial defense gene is soxR (SEQ ID NO: 12), or modified version thereof. In some embodiments of this aspect and all other aspects described herein, an inhibitor of a non-SOS pathway bacterial defense gene is selected from the group of: marR (SEQ ID NO:10), arc (SEQ ID NO:11), soxR (SEQ ID NO:12), fur (SEQ ID NO:13), crp (SEQ ID NO:14), icdA (SEQ ID NO:15), craA (SEQ ID NO:16) or ompA (SEQ ID NO:17) or modified version thereof. In some embodiments, a non-SOS repressor expressed by a repressor-engineered bacteriophage is soxR (SEQ ID NO: 12) which represses soxS and protects against oxidative stress.

In other embodiments of this aspect of the invention, a repressor-engineered bacteriophage can express an repressor, or fragment thereof, of at least one, or at least two or at least three or more SOS response genes, such as, but not limited to lexA, marR, arc, soxR, fur, crp, icdA, craA or ompA. Other repressors known by a skilled artisan are also encompassed for use in repressor-engineered bacteriophages. In some embodiments, repressor-engineered bacteriophages are used in combination with antimicrobial agents which trigger the SOS response, or trigger DNA damage, such as, for example fluoroquinolones, ciprofloxacin and β-lactams.

In other embodiments of this aspect of the invention, an agent encoded by the nucleic acid of a repressor engineered bacteriophage which inhibits a non-SOS defense gene can inhibit any gene listed in Table 2.

TABLE 2 Examples of non-SOS defense genes which can be inhibited by a repressor or an inhibitor expressed by a repressor-engineered bacteriophage. Table 2: Examples of non-SOS defense genes which can be inhibited by an repressor or inhibitor expressed by a repressor-engineered bacteriophage acrA acrB atpA bdm BW25113 cedA cysB dacA dapF dcd ddlB dedD degP deoT dinB dksA dnaK elaD emtA envC envZ fabF fepC fis fkpB folB gntY gor gpmB gpmM gshA gshB hflK hfq hns hrpA hscA hscB ihfA JW5115 JW5360 JW5474 lon lpdA lpp lptB mrcB msbB nagA nudB oxyR pal pal pgmB phoP plsX ppiB prfC proW pstA pstS qmcA recA recB recC recG recN recO resA rfaC rfaD rfaE rfaG rfaH rffA rimK rluB rnt rpe rpiA rplI rpmE rpmF rpmJ rpoN rpsF rpsU rrmJ rseA ruvA ruvC sapC secG skp smpA sufI surA tatB tatC tolC tolR tonB trxA tusC tusD typA ubiG uvrA uvrC uvrD xapR xseA xseB ybcN ybdN ybeD ybeY ybgC ybgF ybhT ybjL ycbR yceD ychJ yciM yciS ydfP ydhT ydjI yfgC yfgL yfiH ygcO ygdD yhdP yidD yiiU yjjY ylcG ymfI yneE

In some embodiments, a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can be used in combination with selected antimicrobial agents, for example, where the repressor-engineered bacteriophage encodes an agent which inhibits a gene listed in Table 2A, such a repressor-engineered bacteriophage can be used in combination with a ciprofloxacin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 2B can be used in combination with a vancomycin antimicrobial agent or a variant or analogue thereof. Similarly, in other embodiments a repressor-engineered bacteriophage which inhibits a non-SOS defense gene can encode an agent which inhibits a gene listed in Table 2C, 2D, 2E, 2F and 2G can be used in combination with a rifampicin antimicrobial agent, or a ampicillin antimicrobial agent or a sulfmethaxazone antimicrobial agent or a gentamicin antimicrobial agent or a metronidazole antimicrobial agent, respectively, or a variant or analogue thereof. In some embodiments, other non-SOS response genes which can be inhibited or repressed in a repressor-engineered bacteriophage includes, for example, but not limited to genes induced by DNA damage, such as DinD, DinF, DinG, Dinl, DinP, OraA, PolB, RecA, RecN, RuvA, RuvB, SbmC, Ssb, SulA, UmuC, UmuD, UvrA, UvrB, and Uvr D, as discussed in Dwyer et al., Mol Systems Biology, 2007; 3; 1-15, which is incorporated herein in its entirety by reference. In another embodiment, other non-SOS response genes which can be inhibited or repressed in a repressor-engineered bacteriophage includes, for example, but not limited to genes induced by oxidative damage, such as MarA, MarB, MarR, SodA and SoxS, as discussed in Dwyer et al., Mol Systems Biology, 2007; 3; 1-15, which is incorporated herein in its entirety by reference.

Susceptibility Agent-Engineered Bacteriophages

Another aspect of the present invention relates to an engineered bacteriophage which comprises a nucleic acid encoding an agent, such as but not limited to a protein, which increases the susceptibility of a bacteria to an antimicrobial agent. Such herein engineered bacteriophage which comprises a nucleic acid encoding an agent which increases the susceptibility of a bacteria to an antimicrobial agent can be referred to herein as an “susceptibility agent-engineered bacteriophage” or “susceptibility-engineered bacteriophage” but are also encompassed under the definition of a “repressor-engineered bacteriophage” In some embodiments of this aspect, and all other aspects described herein, such an agent which increases the susceptibility of a bacteria to an antimicrobial agent is referred to as a “susceptibility agent” and refers to any agent which increases the bacteria's susceptibility to the antimicrobial agent by about at least 10% or about at least 15%, or about at least 20% or about at least 30% or about at least 50% or more than 50%, or any integer between 10% and 50% or more, as compared to the use of the antimicrobial agent alone. In one embodiment, a susceptibility agent is an agent which specifically targets a bacteria cell. In another embodiment, a susceptibility agent modifies (i.e. inhibits or activates) a pathway which is specifically expressed in bacterial cells. In one embodiment, a susceptibility agent is an agent which has an additive effect of the efficacy of the antimicrobial agent (i.e. the agent has an additive effect of the killing efficacy or inhibition of growth by the antimicrobial agent). In a preferred embodiment, a susceptibility agent is an agent which has a synergistic effect on the efficacy of the antimicrobial agent (i.e. the agent has a synergistic effect of the killing efficacy or inhibition of growth by the antimicrobial agent).

In one embodiment, a susceptibility agent increases the entry of an antimicrobial agent into a bacterial cell, for example, a susceptibility agent is a porin or porin-like protein, such as but is not limited to, protein OmpF, and Beta barrel porins, or other members of the outer membrane porin (OMP)) functional superfamily which include, but are not limited to those disclosed in world wide web site: “//biocyc.org/ECOLI/NEW-IMAGE?object=BC-4.1.B”, or a OMP family member listed in Table 3 as disclosed herein, or a variant or fragment thereof.

TABLE 3 Examples of members of the Outer Membrane Porin (OMP) Superfamily which can be expressed as a susceptibility agent by a susceptibility-agent engineered bacteriophage. Table 3: Members of The Outer Membrane Porin (OMP) Functional Superfamily bglH (carbohydrate-specific outer membrane porin, cryptic), btuB (outer membrane receptor for transport of vitamin B12, E colicins, and bacteriophage BF23), fadL (long-chain fatty acid outer membrane transporter; sensitivity to phage T2), fecA (outer membrane receptor; citrate-dependent iron transport, outer membrane receptor), fepA (FepA, outer membrane receptor for ferric enterobactin (enterochelin) and colicins B and D), fhuA (FhuA outer membrane protein receptor for ferrichrome, colicin M, and phages T1, T5, and phi80), fhuE (outer membrane receptor for ferric iron uptake), fiu (putative outer membrane receptor for iron transport), lamB, mdtQ (putative channel/filament protein), ompA (outer membrane protein 3a (II*;G;d)), ompC, ompF, ompG (outer membrane porin OmpG), ompL (predicted outer membrane porin L), ompN (outer membrane pore protein N, non-specific), ompW (OmpW, outer membrane protein), pgaA (partially N-deacetylated poly-?-1,6-N-acetyl-D-glucosamine outer membrane porin), phoE tolB tolC (TolC outer membrane channel), tsx (nucleoside channel; receptor of phage T6 and colicin K), yncD (probable TonB-dependent receptor

In another embodiment, a susceptibility agent is an agent, such as but not limited to a protein, which increases iron-sulfur clusters in the bacteria cell and/or increases oxidative stress or hydroxyl radicals in the bacteria. Examples of a susceptibility agent which increases the iron-sulfur clusters include agents which modultate (i.e. increase or decrease) the Fenton reaction to form hydroxyl radicals, as disclosed in Kahanski et al., Cell, 2007, 130; 797-810, which is incorporated herein by reference in its entirety. Examples of a susceptibility agent to be expressed by a susceptibility-engineered bacteriophage include, for example, those listed in Table 4, or a fragment or variant thereof or described in world-wide-web site “biocyc.org/ECOLI/NEW-IMAGE?type=COMPOUND&object=CPD-7”. Examples of susceptibility agents which increases iron-sulfur clusters in the bacteria cell include, for example but not limited to IscA, IscR, IscS and IscU. Examples of susceptibility agents which increase iron uptake and utilization and can be used as susceptibility agents include, for example but not limited to EntC, ExbB, ExbD, Fecl, FecR, FepB, FepC, Fes, FhuA, FhuB, FhuC, FhuF, NrdH, Nrdl, SodA and TonB, as discussed in Dwyer et al., Mol Systems Biology, 2007; 3; 1-15, which is incorporated herein in its entirety by reference.

TABLE 4 Examples of genes which can be expressed as a susceptibility agent by a susceptibility-engineered bacteriophage to increase iron cluster formation in bacteria. Table 4: Example of susceptibility agents which increase iron clusters Cofactor of: serine deaminase, L-serine deaminase, L-serine deaminase, pyruvate formate-lyase activating enzyme, 2,4-dienoyl-CoA reductase Prosthetic Group of: biotin synthase, dihydroxy-acid dehydratase, dihydroxy-acid dehydratase, lysine 2,3-aminomutase, NADH:ubiquinone oxidoreductase, sulfite reductase-(NADPH), aconitase B, fumarase A, aconitase, fumarase B, anaerobic coproporphyrinogen III oxidase, succinate dehydrogenase, nitrate reductase, flavin reductase, aconitase B, fumarate reductase Cofactor or Prosthetic Group of: quinolinate synthase, ribonucleoside triphosphate reductase activase, 23S ribosomal RNA 5-methyluridine methyltransferase

In some embodiments, a susceptibility agent is an agent such as CsrA, which is described in world-wide web site: “biocyc.org/ECOLI/NEW-IMAGE?type=ENZYME&object=CPLX0-1041.

In some embodiments, a susceptibility agent is not a chemotherapeutic agent. In another embodiment, a susceptibility agent is not a toxin protein, and in another embodiment, a susceptibility agent is not a bacterial toxin protein or molecule.

Modification of Inhibitor-Engineered Bacteriophages, Repressor-Engineered Bacteriophages and Susceptibility-Agent Engineered Bacteriophages

In another embodiment, an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or a susceptibility-engineered bacteriophage can be further be modified to comprise nucleic acids which encode phage resistant genes, for example any phage resistant gene known by persons of ordinary skill in the art, such as, but not limited to AbiZ (as disclosed in U.S. Pat. No. 7,169,911 which is incorporated herein by reference), sie₂₀₀₉, sie_(IL409), sie_(F7/2A), orf2, orf258, orf2(M), olfD, orf304, orfB, orf142, orf203, orf3 ψ, orf2 ψ gp34, gp33, gp32, gp25, glo, orfl, SieA, SieB, imm, sim, rexB (McGrath et al., Mol Microbiol, 2002, 43; 509-520).

In another embodiment, the inhibitor-engineered bacteriophages and/or repressor-engineered bacteriophages and/or a susceptibility-engineered bacteriophage can be further be modified to comprise nucleic acids which encode enzymes which assist in breaking down or degrading the biofilm matrix, for example any phage resistant gene known as a biofilm degrading enzyme by persons of ordinary skill in the art, such as, but not limited to Dispersin D aminopeptidase, amylase, carbohydrase, carboxypeptidase, catalase, cellulase, chitinase, cutinase, cyclodextrin glycosyltransferase, deoxyribonuclease, esterase, alpha-galactosidase, beta-galactosidase, glucoamylase, alpha-glucosidase, beta-glucosidase, haloperoxidase, invertase, laccase, lipase, mannosidase, oxidase, pectinolytic enzyme, peptidoglutaminase, peroxidase, phytase, polyphenoloxidase, proteolytic enzyme, ribonuclease, transglutaminase, xylanase or lyase. In other embodiments, the enzyme is selected from the group consisting of cellulases, such as glycosyl hydroxylase family of cellulases, such as glycosyl hydroxylase 5 family of enzymes also called cellulase A; polyglucosamine (PGA) depolymerases; and colonic acid depolymerases, such as 1,4-L-fucodise hydrolase (see, e.g., Verhoef R. et al., Characterization of a 1,4-beta-fucoside hydrolase degrading colanic acid, Carbohydr Res. 2005 Aug. 15; 340(11):1780-8), depolymerazing alginase, and DNase I, or combinations thereof, as disclosed in the methods as disclosed in U.S. patent application Ser. No. 11/662,551 and International Patent Application Wo2006/137847 and provisional patent application 61/014,518, which are specifically incorporated herein in their entirety by reference.

In another embodiment, the inhibitor-engineered bacteriophages and/or repressor-engineered bacteriophages and/or a susceptibility-engineered bacteriophage can be further be modified in a species-specific manner, for example, one can modify or select the bacteriophage on the basis for its infectivity of specific bacteria.

A bacteriophage to be engineered or developed into an inhibitor-engineered bacteriophage or repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage can be any bacteriophage as known by a person of ordinary skill in the art. In some embodiments, an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage is derived from any or a combination of bacteriophages listed in Table 5.

In some embodiments, a bacteriophage which is engineered to become an engineered bacteriophage as disclosed herein is a lytic bacteriophage or lysogenic bacteriophage, or any bacteriophage that infects E. coli, P. aeriginosa, S. aureaus, E. facalis and the like. Such bacteriophages are well known to one skilled in the art and are listed in Table 5, and include, but are not limited to, lambda phages, M13, T7, T3, and T-even and T-even like phages, such as T2, and T4, and RB69; also phages such as Pfl, Pf4, Bacteroides fragilis phage B40-8 and coliphage MS-2 can be used. For example, lambda phage attacks E. coli by attaching itself to the outside of the bacteria and injecting its DNA into the bacteria. Once injected into its new host, a bacteriophage uses E. coli's genetic machinery to transcribe its genes. Any of the known phages can be engineered to express an agent that inhibits an antibiotic resistance gene or cell survival gene, or alternatively express a repressor agent or an inhibitor of a non-SOS defense gene for a repressor-engineered bacteriophage, or express a susceptibility agent for a susceptibility-engineered bacteriophage as described herein.

In some embodiments, bacteriophages which have been engineered to be more efficient cloning vectors or naturally lack a gene important in infecting all bacteria, such as male and female bacteria can be used to generate engineered bacteriophages as disclosed herein. Typically, bacteriophages have been engineered to lack genes for infecting all variants and species of bacteria can have reduced capacity to replicate in naturally occurring bacteria thus limiting the use of such phages in degradation of biofilm produced by the naturally occurring bacteria.

For example, the capsid protein of phage T7, gene 10, comes in two forms, the major product 10A (36 kDa) and the minor product 10B (41 kDa) (Condron, B. G., Atkins, J. F., and Gesteland, R. F. 1991. Frameshifting in gene 10 of bacteriophage T7. J. Bacteriol. 173:6998-7003). Capsid protein 10B is produced by frameshifting near the end of the coding region of 10A. NOVAGEN® modified gene 10 in T7 to remove the frameshifting site so that only 10B with the attached user-introduced peptide for surface display is produced (U.S. Pat. No. 5,766,905. 1998. Cytoplasmic bacteriophage display system, which is incorporated in its entirety herein by reference). The 10B-enzyme fusion product is too large to make up the entire phage capsid because the enzymes that are typically introduced into phages, such as T7, are large (greater than a few hundred amino acids). As a result, T7select 10-3b must be grown in host bacterial strains that produce wild-type 10A capsid protein, such as BLT5403 or BLT5615, so that enough 10A is available to be interspersed with the 10B-enzyme fusion product to allow replication of phage (U.S. Pat. No. 5,766,905. 1998. Cytoplasmic bacteriophage display system, which is incorporated in its entirety herein by reference). However, because most biofilm-forming E. coli do not produce wild-type 10A capsid protein, this limits the ability of T7select 10-3b displaying large enzymes on their surface to propagate within and lyse some important strains of E. coli. Accordingly, in some embodiments, the present invention provides genetically engineered phages that in addition to comprising inhibitors to cell survival genes or antibiotic resistance genes, or nucleic acids encoding repressor proteins, also express all the essential genes for virus replication in naturally occurring bacterial strains. In one embodiment, the invention provides an engineered T7select 10-3b phage that expresses both cellulase and 10A capsid protein.

It is known that wild-type T7 does not productively infect male (F plasmid-containing) E. coli because of interactions between the F plasmid protein PifA and T7 genes 1.2 or 10 (Garcia, L. R., and Molineux, I. J. 1995. Incomplete entry of bacteriophage T7 DNA into F plasmid-containing Escherichia coli. J. Bacteriol. 177:4077-4083.). F plasmid-containing E. coli infected by T7 die but do not lyse or release large numbers of T7 (Garcia, L. R., and Molineux, I. J. 1995. Incomplete entry of bacteriophage T7 DNA into F plasmid-containing Escherichia coli. J. Bacteriol. 177:4077-4083). Wild-type T3 grows normally on male cells because of T3's gene 1.2 product (Garcia, L. R., and Molineux, I. J. 1995, Id.). When T3 gene 1.2 is expressed in wild-type T7, T7 is able to productively infect male cells (Garcia, L. R., and Molineux, I. J. 1995. Id).

Because many biofilm-producing E. coli contain the F plasmid (Ghigo, et al., 2001. Natural conjugative plasmids induce bacterial biofilm development. Nature. 412:442-445), it is important, although not necessary, for an engineered bacteriophage to be able to productively infect also male cells. Therefore, in addition to engineering the phage to display a biofilm degrading enzyme on its surface, one can also engineer it to express the gene necessary for infecting the male bacteria. For example, one can use the modification described by Garcia and Molineux (Garcia, L. R., and Molineux, I. J. 1995. Incomplete entry of bacteriophage T7 DNA into F plasmid-containing Escherichia coli. J. Bacteriol. 177:4077-4083) to express T3 gene 1.2 in T7.

Nucleic Acid Inhibitors of Antibiotic Resistance Genes and/or Cell Survival Genes for Inhibitor-Engineered Bacteriophages or Nucleic Acid Inhibitors of Non-SOS Defense Genes in Repressor-Engineered Bacteriophages.

In some embodiments of aspects of the invention involving inhibitor-engineered bacteriophages, agents that inhibit an antibiotic resistance gene and/or a cell survival gene is a nucleic acid. In another embodiments, repressor-engineered bacteriophages comprise nucleic acids which inhibit non-SOS defense genes, such as those listed in Table 2, and Tables 2A-2F. An antibiotic resistance gene and/or cell survival gene and/or non-SOS defense gene can be inhibited by inhibition of the expression of such antibiotic resistance proteins and/or cell survival polypeptide or non-SOS defense gene or by “gene silencing” methods commonly known by persons of ordinary skill in the art. A nucleic acid inhibitor of an antibiotic resistance gene and/or a cell survival gene or non-SOS defense gene, includes for example, but is not limited to, RNA interference-inducing (RNAi) molecules, for example but are not limited to siRNA, dsRNA, stRNA, shRNA, miRNA and modified versions thereof, where the RNA interference molecule gene silences the expression of the antibiotic resistance gene and/or cell survival gene non SOS-defense gene. In some embodiments, the nucleic acid inhibitor of an antibiotic resistance gene and/or cell survival gene and/or non-SOS defense gene is an anti-sense oligonucleic acid, or a nucleic acid analogue, for example but are not limited to DNA, RNA, peptide-nucleic acid (PNA), pseudo-complementary PNA (pc-PNA), or locked nucleic acid (LNA) and the like. In alternative embodiments, the nucleic acid is DNA or RNA, and nucleic acid analogues, for example PNA, pcPNA and LNA. A nucleic acid can be single or double stranded, and can be selected from a group comprising nucleic acid encoding a protein of interest, oligonucleotides, PNA, etc. Such nucleic acid inhibitors include for example, but are not limited to, a nucleic acid sequence encoding a protein that is a transcriptional repressor, or an antisense molecule, or a ribozyme, or a small inhibitory nucleic acid sequence such as a RNAi, an shRNAi, an siRNA, a micro RNAi (miRNA), an antisense oligonucleotide etc.

In some embodiments, a nucleic acid inhibitor of an antibiotic resistance gene and/or a cell survival gene and/or non-SOS defense gene can be for example, but not are limited to, paired termini antisense, an example of which is disclosed in FIG. 8 and disclosed in Nakashima, et al., (2006) Nucleic Acids Res 34: e138, which in incorporated herein in its entirety by reference.

In some embodiments of this aspect and all aspects described herein, a single-stranded RNA (ssRNA), a form of RNA endogenously found in eukaryotic cells can be used to form an RNAi molecule. Cellular ssRNA molecules include messenger RNAs (and the progenitor pre-messenger RNAs), small nuclear RNAs, small nucleolar RNAs, transfer RNAs and ribosomal RNAs. Double-stranded RNA (dsRNA) induces a size-dependent immune response such that dsRNA larger than 30 bp activates the interferon response, while shorter dsRNAs feed into the cell's endogenous RNA interference machinery downstream of the Dicer enzyme.

RNA interference (RNAi) provides a powerful approach for inhibiting the expression of selected target polypeptides. RNAi uses small interfering RNA (siRNA) duplexes that target the messenger RNA encoding the target polypeptide for selective degradation. siRNA-dependent post-transcriptional silencing of gene expression involves cutting the target messenger RNA molecule at a site guided by the siRNA.

RNA interference (RNAi) is an evolutionally conserved process whereby the expression or introduction of RNA of a sequence that is identical or highly similar to a target gene results in the sequence specific degradation or specific post-transcriptional gene silencing (PTGS) of messenger RNA (mRNA) transcribed from that targeted gene (see Coburn, G. and Cullen, B. (2002) J. of Virology 76(18):9225), thereby inhibiting expression of the target gene. In one embodiment, the RNA is double stranded RNA (dsRNA). This process has been described in plants, invertebrates, and mammalian cells. In nature, RNAi is initiated by the dsRNA-specific endonuclease Dicer, which promotes processive cleavage of long dsRNA into double-stranded fragments termed siRNAs. siRNAs are incorporated into a protein complex (termed “RNA induced silencing complex,” or “RISC”) that recognizes and cleaves target mRNAs. RNAi can also be initiated by introducing nucleic acid molecules, e.g., synthetic siRNAs or RNA interfering agents, to inhibit or silence the expression of a target genes, such an antibiotic resistance gene and/or cell survival gene and/or non-SOS defense gene. As used herein, “inhibition of target gene expression” includes any decrease in expression or protein activity or level of the target gene (i.e. antibiotic resistance gene) or protein encoded by the target gene (i.e. antibiotic resistance protein) as compared to the level in the absence of an RNA interference (RNAi) molecule. The decrease in expression or protein level as result of gene silencing can be of at least 30%, 40%, 50%, 60%, 70%, 80%, 90%, 95% or 99% or more as compared to the expression of a target gene or the activity or level of the protein (i.e. expression of the antibiotic resistance gene or antibiotic resistance protein) encoded by a target gene which has not been targeted and gene silenced by an RNA interfering (RNAi) agent.

As used herein, the term “short interfering RNA” (siRNA), also referred to herein as “small interfering RNA” is defined as an agent which functions to inhibit expression of a target gene, e.g., by RNAi. An siRNA can be chemically synthesized, can be produced by in vitro transcription, or can be produced within a host cell. In one embodiment, siRNA is a double stranded RNA (dsRNA) molecule of about 15 to about 40 nucleotides in length, preferably about 15 to about 28 nucleotides, more preferably about 19 to about 25 nucleotides in length, and more preferably about 19, 20, 21, 22, or 23 nucleotides in length, and can contain a 3′ and/or 5′ overhang on each strand having a length of about 0, 1, 2, 3, 4, or 5 nucleotides. The length of the overhang is independent between the two strands, i.e., the length of the overhang on one strand is not dependent on the length of the overhang on the second strand. In some embodiments, the siRNA is capable of promoting RNA interference through degradation or specific post-transcriptional gene silencing (PTGS) of the target messenger RNA (mRNA).

siRNAs also include small hairpin (also called stem loop) RNAs (shRNAs). In one embodiment, these shRNAs are composed of a short (e.g., about 19 to about 25 nucleotide) antisense strand, followed by a nucleotide loop of about 5 to about 9 nucleotides, and the analogous sense strand. Alternatively, the sense strand can precede the nucleotide loop structure and the antisense strand can follow. These shRNAs can be contained in plasmids, retroviruses, and lentiviruses and expressed from, for example, the pol III U6 promoter, or another promoter (see, e.g., Stewart, et al. (2003) RNA Apr; 9(4):493-501, incorporated by reference herein in its entirety).

Typically a target gene or sequence targeted by gene silencing by an RNA interfering (RNAi) agent can be a cellular gene or genomic sequence encoding an antibiotic resistant protein or a cell survival protein. In some embodiments, an siRNA can be substantially homologous to the target gene or genomic sequence, or a fragment thereof. As used in this context, the term “homologous” is defined as being substantially identical, sufficiently complementary, or similar to the target mRNA, or a fragment thereof, to effect RNA interference of the target. In addition to native RNA molecules, RNA suitable for inhibiting or interfering with the expression of a target sequence include RNA derivatives and analogs. Preferably, the siRNA is identical to its target.

The siRNA preferably targets only one sequence. Each of the RNA interfering agents, such as siRNAs, can be screened for potential off-target effects by, for example, expression profiling. Such methods are known to one skilled in the art and are described, for example, in Jackson et al, Nature Biotechnology 6:635-637, 2003. In addition to expression profiling, one can also screen the potential target sequences for similar sequences in the sequence databases to identify potential sequences which can have off-target effects. For example, according to Jackson et al. (Id.) 15, or perhaps as few as 11 contiguous nucleotides of sequence identity are sufficient to direct silencing of non-targeted transcripts. Therefore, one can initially screen the proposed siRNAs to avoid potential off-target silencing using the sequence identity analysis by any known sequence comparison methods, such as BLAST (Basic Local Alignment Search Tool available from or at NIBI).

siRNA molecules need not be limited to those molecules containing only RNA, but, for example, further encompasses chemically modified nucleotides and non-nucleotides, and also include molecules wherein a ribose sugar molecule is substituted for another sugar molecule or a molecule which performs a similar function. Moreover, a non-natural linkage between nucleotide residues can be used, such as a phosphorothioate linkage. For example, siRNA containing D-arabinofuranosyl structures in place of the naturally-occurring D-ribonucleosides found in RNA can be used in RNAi molecules according to the present invention (U.S. Pat. No. 5,177,196, which is incorporated herein by reference). Other examples include RNA molecules containing the o-linkage between the sugar and the heterocyclic base of the nucleoside, which confers nuclease resistance and tight complementary strand binding to the oligonucleotidesmolecules similar to the oligonucleotides containing 2′-O-methyl ribose, arabinose and particularly D-arabinose (U.S. Pat. No. 5,177,196, which is incorporated herein in its entirety by reference).

The RNA strand can be derivatized with a reactive functional group of a reporter group, such as a fluorophore. Particularly useful derivatives are modified at a terminus or termini of an RNA strand, typically the 3′ terminus of the sense strand. For example, the 2′-hydroxyl at the 3′ terminus can be readily and selectively derivatized with a variety of groups.

Other useful RNA derivatives incorporate nucleotides having modified carbohydrate moieties, such as 2′O-alkylated residues or 2′-O-methyl ribosyl derivatives and 2′-O-fluoro ribosyl derivatives. The RNA bases can also be modified. Any modified base useful for inhibiting or interfering with the expression of a target sequence can be used. For example, halogenated bases, such as 5-bromouracil and 5-iodouracil can be incorporated. The bases can also be alkylated, for example, 7-methylguanosine can be incorporated in place of a guanosine residue. Non-natural bases that yield successful inhibition can also be incorporated.

The most preferred siRNA modifications include 2′-deoxy-2′-fluorouridine or locked nucleic acid (LNA) nucleotides and RNA duplexes containing either phosphodiester or varying numbers of phosphorothioate linkages. Such modifications are known to one skilled in the art and are described, for example, in Braasch et al., Biochemistry, 42: 7967-7975, 2003. Most of the useful modifications to the siRNA molecules can be introduced using chemistries established for antisense oligonucleotide technology. Preferably, the modifications involve minimal 2′-O-methyl modification, preferably excluding such modification. Modifications also preferably exclude modifications of the free 5′-hydroxyl groups of the siRNA.

siRNA and miRNA molecules having various “tails” covalently attached to either their 3′- or to their 5′-ends, or to both, are also known in the art and can be used to stabilize the siRNA and miRNA molecules delivered using the methods of the present invention. Generally speaking, intercalating groups, various kinds of reporter groups and lipophilic groups attached to the 3′ or 5′ ends of the RNA molecules are well known to one skilled in the art and are useful according to the methods of the present invention. Descriptions of syntheses of 3′-cholesterol or 3′-acridine modified oligonucleotides applicable to preparation of modified RNA molecules useful according to the present invention can be found, for example, in the articles: Gamper, H. B., Reed, M. W., Cox, T., Virosco, J. S., Adams, A. D., Gall, A., Scholler, J. K., and Meyer, R. B. (1993) Facile Preparation and Exonuclease Stability of 3′-Modified Oligodeoxynucleotides. Nucleic Acids Res. 21 145-150; and Reed, M. W., Adams, A. D., Nelson, J. S., and Meyer, R. B., Jr. (1991) Acridine and Cholesterol-Derivatized Solid Supports for Improved Synthesis of 3′-Modified Oligonucleotides. Bioconjugate Chem. 2 217-225 (1993).

Other siRNAs useful for targeting Lp-PLA₂ expression can be readily designed and tested. Accordingly, siRNAs useful for the methods described herein include siRNA molecules of about 15 to about 40 or about 15 to about 28 nucleotides in length. Preferably, the siRNA molecules have a length of about 19 to about 25 nucleotides. More preferably, the siRNA molecules have a length of about 19, 20, 21, or 22 nucleotides. The siRNA molecules can also comprise a 3′ hydroxyl group. The siRNA molecules can be single-stranded or double stranded; such molecules can be blunt ended or comprise overhanging ends (e.g., 5′, 3′). In specific embodiments, the RNA molecule is double stranded and either blunt ended or comprises overhanging ends.

In one embodiment, at least one strand of the RNA molecule has a 3′ overhang from about 0 to about 6 nucleotides (e.g., pyrimidine nucleotides, purine nucleotides) in length. In other embodiments, the 3′ overhang is from about 1 to about 5 nucleotides, from about 1 to about 3 nucleotides and from about 2 to about 4 nucleotides in length. In one embodiment the RNA molecule is double stranded—one strand has a 3′ overhang and the other strand can be blunt-ended or have an overhang. In the embodiment in which the RNA molecule is double stranded and both strands comprise an overhang, the length of the overhangs can be the same or different for each strand. In a particular embodiment, the RNA of the present invention comprises about 19, 20, 21, or 22 nucleotides which are paired and which have overhangs of from about 1 to about 3, particularly about 2, nucleotides on both 3′ ends of the RNA. In one embodiment, the 3′ overhangs can be stabilized against degradation. In a preferred embodiment, the RNA is stabilized by including purine nucleotides, such as adenosine or guanosine nucleotides. Alternatively, substitution of pyrimidine nucleotides by modified analogues, e.g., substitution of uridine 2 nucleotide 3′ overhangs by 2′-deoxythymidine is tolerated and does not affect the efficiency of RNAi. The absence of a 2′ hydroxyl significantly enhances the nuclease resistance of the overhang in tissue culture medium.

In some embodiments, assessment of the expression and/or knock down of antibiotic resistance gene and/or cell survival gene protein and/or non-SOS defense genes using such RNAi agents such as antisense RNA can be determined by a person of ordinary skill in the art determining the viability of a bacteria expressing such a RNAi agent in the presence of an antimicrobial agent. In some embodiments, bacterial cell viability can be determined by using commercially available kits. Others can be readily prepared by those of skill in the art based on the known sequence of the target mRNA. To avoid doubt, the nucleic acid sequence which can be used to design nucleic acid inhibitors for inhibitor-engineered bacteriophages as disclosed herein can be based on any antibiotic resistance gene or any SOS gene or any non-SOS defense gene listed in Tables 2 or 2A-2F as disclosed herein.

siRNA sequences are chosen to maximize the uptake of the antisense (guide) strand of the siRNA into RISC and thereby maximize the ability of the inhibitor to target RISC to target antibiotic resistance gene or cell survival gene mRNA for degradation. This can be accomplished by scanning for sequences that have the lowest free energy of binding at the 5′-terminus of the antisense strand. The lower free energy leads to an enhancement of the unwinding of the 5′-end of the antisense strand of the siRNA duplex, thereby ensuring that the antisense strand will be taken up by RISC and direct the sequence-specific cleavage of the targeted mRNA.

RNA interference molecules and nucleic acid inhibitors useful in the methods as disclosed herein can be produced using any known techniques such as direct chemical synthesis, through processing of longer double stranded RNAs by exposure to recombinant Dicer protein or Drosophila embryo lysates, through an in vitro system derived from S2 cells, using phage RNA polymerase, RNA-dependant RNA polymerase, and DNA based vectors. Use of cell lysates or in vitro processing can further involve the subsequent isolation of the short, for example, about 21-23 nucleotide, siRNAs from the lysate, etc. Chemical synthesis usually proceeds by making two single stranded RNA-oligomers followed by the annealing of the two single stranded oligomers into a double stranded RNA. Other examples include methods disclosed in WO 99/32619 and WO 01/68836, which are incorporated herein by reference, teach chemical and enzymatic synthesis of siRNA. Moreover, numerous commercial services are available for designing and manufacturing specific siRNAs (see, e.g., QIAGEN Inc., Valencia, Calif. and AMBION Inc., Austin, Tex.)

In one embodiment, the nucleic acid inhibitors of antibiotic resistance genes and/or cell survival genes can be obtained synthetically, for example, by chemically synthesizing a nucleic acid by any method of synthesis known to the skilled artisan. The synthesized nucleic acid inhibitors of antibiotic resistance genes and/or cell survival genes can then be purified by any method known in the art. Methods for chemical synthesis of nucleic acids include, but are not limited to, in vitro chemical synthesis using phosphotriester, phosphate or phosphoramidite chemistry and solid phase techniques, or via deoxynucleoside H-phosphonate intermediates (see U.S. Pat. No. 5,705,629 to Bhongle).

In some circumstances, for example, where increased nuclease stability is desired, nucleic acids having nucleic acid analogs and/or modified internucleoside linkages can be preferred. Nucleic acids containing modified internucleoside linkages can also be synthesized using reagents and methods that are well known in the art. For example, methods of synthesizing nucleic acids containing phosphonate phosphorothioate, phosphorodithioate, phosphoramidate methoxyethyl phosphoramidate, formacetal, thioformacetal, diisopropylsilyl, acetamidate, carbamate, dimethylene-sulfide (—CH₂S—CH₂), dimethylene-sulfoxide (—CH₂—SO—CH₂), dimethylene-sulfone (—CH₂—SO₂CH₂), 2′-O-alkyl, and 2′-deoxy-2′-fluoro′ phosphorothioate internucleoside linkages are well known in the art (see Uhlmann et al., 1990, Chem. Rev. 90:543-584; Schneider et al., 1990, Tetrahedron Lett. 31:335 and references cited therein). U.S. Pat. Nos. 5,614,617 and 5,223,618 to Cook, et al., U.S. Pat. No. 5,714,606 to Acevedo, et al, U.S. Pat. No. 5,378,825 to Cook, et al., U.S. Pat. No. 5,672,697 and U.S. Pat. No. 5,466,786 to Buhr, et al., U.S. Pat. No. 5,777,092 to Cook, et al., U.S. Pat. No. 5,602,240 to De Mesmacker, et al., U.S. Pat. No. 5,610,289 to Cook, et al. and U.S. Pat. No. 5,858,988 to Wang, also describe nucleic acid analogs for enhanced nuclease stability and cellular uptake.

Synthetic siRNA molecules, including shRNA molecules, can be obtained using a number of techniques known to those of skill in the art. For example, the siRNA molecule can be chemically synthesized or recombinantly produced using methods known in the art, such as using appropriately protected ribonucleoside phosphoramidites and a conventional DNA/RNA synthesizer (see, e.g., Elbashir, S. M. et al. (2001) Nature 411:494-498; Elbashir, S. M., W. Lendeckel and T. Tuschl (2001) Genes & Development 15:188-200; Harborth, J. et al. (2001) J. Cell Science 114:4557-4565; Masters, J. R. et al. (2001) Proc. Natl. Acad. Sci., USA 98:8012-8017; and Tuschl, T. et al. (1999) Genes & Development 13:3191-3197). Alternatively, several commercial RNA synthesis suppliers are available including, but are not limited to, Proligo (Hamburg, Germany), Dharmacon Research (Lafayette, Colo., USA), Pierce Chemical (part of Perbio Science, Rockford, Ill., USA), Glen Research (Sterling, Va., USA), ChemGenes (Ashland, Mass., USA), and Cruachem (Glasgow, UK). As such, siRNA molecules are not overly difficult to synthesize and are readily provided in a quality suitable for RNAi. In addition, dsRNAs can be expressed as stem loop structures encoded by plasmid vectors, retroviruses and lentiviruses (Paddison, P. J. et al. (2002) Genes Dev. 16:948-958; McManus, M. T. et al. (2002) RNA 8:842-850; Paul, C. P. et al. (2002) Nat. Biotechnol. 20:505-508; Miyagishi, M. et al. (2002) Nat. Biotechnol. 20:497-500; Sui, G. et al. (2002) Proc. Natl. Acad. Sci., USA 99:5515-5520; Brummelkamp, T. et al. (2002) Cancer Cell 2:243; Lee, N. S., et al. (2002) Nat. Biotechnol. 20:500-505; Yu, J. Y., et al. (2002) Proc. Natl. Acad. Sci., USA 99:6047-6052; Zeng, Y., et al. (2002) Mol. Cell. 9:1327-1333; Rubinson, D. A., et al. (2003) Nat. Genet. 33:401-406; Stewart, S. A., et al. (2003) RNA 9:493-501). These vectors generally have a polIII promoter upstream of the dsRNA and can express sense and antisense RNA strands separately and/or as a hairpin structures. Within cells, Dicer processes the short hairpin RNA (shRNA) into effective siRNA.

The targeted region of the siRNA molecule of the present invention can be selected from a given target gene sequence, e.g., an antibiotic resistance genes and/or cell survival genes coding sequence, beginning from about 25 to 50 nucleotides, from about 50 to 75 nucleotides, or from about 75 to 100 nucleotides downstream of the start codon. Nucleotide sequences can contain 5′ or 3′ UTRs and regions nearby the start codon. One method of designing a siRNA molecule of the present invention involves identifying the 23 nucleotide sequence motif AA(N19)TT (where N can be any nucleotide), and selecting hits with at least 25%, 30%, 35%, 40%, 45%, 50%, 55%, 60%, 65%, 70% or 75% G/C content. The “TT” portion of the sequence is optional. Alternatively, if no such sequence is found, the search can be extended using the motif NA(N21), where N can be any nucleotide. In this situation, the 3′ end of the sense siRNA can be converted to TT to allow for the generation of a symmetric duplex with respect to the sequence composition of the sense and antisense 3′ overhangs. The antisense siRNA molecule can then be synthesized as the complement to nucleotide positions 1 to 21 of the 23 nucleotide sequence motif. The use of symmetric 3′ TT overhangs can be advantageous to ensure that the small interfering ribonucleoprotein particles (siRNPs) are formed with approximately equal ratios of sense and antisense target RNA-cleaving siRNPs (Elbashir et al. (2001) supra and Elbashir et al. 2001 supra). Analysis of sequence databases, including but are not limited to the NCBI, BLAST, Derwent and GenSeq as well as commercially available oligosynthesis software such as OLIGOENGINE®, can also be used to select siRNA sequences against EST libraries to ensure that only one gene is targeted.

Accordingly, the RNAi molecules functioning as nucleic acid inhibitors of antibiotic resistance genes and/or cell survival genes as disclosed herein are for example, but are not limited to, unmodified and modified double stranded (ds) RNA molecules including short-temporal RNA (stRNA), small interfering RNA (siRNA), short-hairpin RNA (shRNA), microRNA (miRNA), double-stranded RNA (dsRNA), (see, e.g. Baulcombe, Science 297:2002-2003, 2002). The dsRNA molecules, e.g. siRNA, also can contain 3′ overhangs, preferably 3′UU or 3′TT overhangs. In one embodiment, the siRNA molecules of the present invention do not include RNA molecules that comprise ssRNA greater than about 30-40 bases, about 40-50 bases, about 50 bases or more. In one embodiment, the siRNA molecules of the present invention are double stranded for more than about 25%, more than about 50%, more than about 60%, more than about 70%, more than about 80%, more than about 90% of their length. In some embodiments, a nucleic acid inhibitor of antibiotic resistance genes and/or cell survival genes is any agent which binds to and inhibits the expression of antibiotic resistance genes and/or cell survival gene mRNA, where the expression of the antibiotic resistance genes and/or cell survival mRNA or a product of transcription of nucleic acid encoded by antibiotic resistance genes and/or cell survival gene is inhibited.

In another embodiment of the invention, agents inhibiting antibiotic resistance genes and/or cell survival genes are catalytic nucleic acid constructs, such as, for example ribozymes, which are capable of cleaving RNA transcripts and thereby preventing the production of wildtype protein. Ribozymes are targeted to and anneal with a particular sequence by virtue of two regions of sequence complementary to the target flanking the ribozyme catalytic site. After binding, the ribozyme cleaves the target in a site specific manner. The design and testing of ribozymes which specifically recognize and cleave sequences of the gene products described herein, for example for cleavage of antibiotic resistance genes and/or cell survival genes or homologues or variants thereof can be achieved by techniques well known to those skilled in the art (for example Lleber and Strauss, (1995) Mol Cell Biol 15:540.551, the disclosure of which is incorporated herein by reference).

Promoters of the Engineered Bacteriophages

In some embodiments of all aspects described herein, an engineered bacteriophage comprises a nucleic acid which expresses an inhibitor to an antibiotic resistance gene (such as in inhibitor-engineered bacteriophages) or a repressor to a SOS gene or a repressor (or inhibitor) to a non-SOS defense gene (in the case of repressor-engineered bacteriophages) or a susceptibility agent (in a case of a susceptibility-agent engineered bacteriophage). In each instance, gene expression from the nucleic acid is regulated by a promoter to which the nucleic acid is operatively linked to. In some embodiments, a promoter is a bacteriophage promoter. One can use any bacteriophage promoter known by one of ordinary skill in the art, for example but not limited to, any promoter listed in Table 6 or disclosed in world-wide web site “partsregistry.org/cgi/partsdb/pgroup.cgi?pgroup=other_regulator&show=1”.

In some embodiments, an agent is protein or polypeptide or RNAi agent that inhibits expression of antibiotic resistance genes and/or cell survival gene, or a non-SOS defense genes. In such embodiments bacteriophage cells can be modified (e.g., by homologous recombination) to provide increased expression of such an agent, for example by replacing, in whole or in part, the naturally occurring bacteriophage promoter with all or part of a heterologous promoter so that the bacteriophage and/or the bacteriophage infected-host cell expresses a high level of the inhibitor agent of antibiotic resistance genes and/or cell survival gene or a repressor or an inhibitor to a non-SOS defense gene or a susceptibility agent. In some embodiments, a heterologous promoter is inserted in such a manner that it is operatively linked to the desired nucleic acid encoding the agent. See, for example, PCT International Publication No. WO 94/12650 by Transkaryotic Therapies, Inc., PCT International Publication No. WO 92/20808 by Cell Genesys, Inc., and PCT International Publication No. WO 91/09955 by Applied Research Systems, which are incorporated herein in their entirety by reference.

In some embodiments, bacteriophages can be engineered as disclosed herein to express an endogenous gene, such as a repressor protein, or a nucleic acid inhibitor of an antibiotic resistance gene or cell survival gene comprising the agent under the control of inducible regulatory elements, in which case the regulatory sequences of the endogenous gene can be replaced by homologous recombination. Gene activation techniques are described in U.S. Pat. No. 5,272,071 to Chappel; U.S. Pat. No. 5,578,461 to Sherwin et al.; PCT/US92/09627 (WO93/09222) by Selden et al.; and PCT/US90/06436 (WO91/06667) by Skoultchi et al, which are all incorporated herein in their entirety by reference.

Other exemplary examples of promoter which can be used include, for example but not limited, Anhydrotetracycline(aTc) promoter, PLtetO-1 (Pubmed Nucleotide# U66309), Arabinose promoter (PBAD), IPTG inducible promoters PTAC (in vectors such as Pubmed Accession #EU546824), PTrc-2, Plac (in vectors such as Pubmed Accession #EU546816), PLlacO-1, PAllacO-1, and Arabinose and IPTG promoters, such as Plac/ara-a. Examples of these promoters are as follows:

Anhydrotetracycline (aTc) promoter, such as PLtetO-1 (Pubmed Nucleotide# U66309): GCATGCTCCCTATCAGTGATAGAGATTGACATCCCTATCAGTGATAGAGATACTGAGCACAT CAGCAGGACGCACTGACCAGGA (SEQ ID NO: 36); Arabinose promoter (PBAD): or modified versions which can be found at world-wide web site: partsregistry.org/wiki/index.php?title=Part:BBa_I13453” AAGAAACCAATTGTCCATATTGCATCAGACATTGCCGTCACTGCGTCTTTTACTGGCTCTTCT CGCTAACCAAACCGGTAACCCCGCTTATTAAAAGCATTCTGTAACAAAGCGGGACCAAAGC CATGACAAAAACGCGTAACAAAAGTGTCTATAATCACGGCAGAAAAGTCCACATTGATTAT TTGCACGGCGTCACACTTTGCTATGCCATAGCATTTTTATCCATAAGATTAGCGGATCCTACC TGACGCTTTTTATCGCAACTCTCTACTGTTTCTCCATA (SEQ ID NO: 37); IPTG promoters: (i) PTAC (in vectors such as Pubmed Accession #EU546824, which is incorporated herein by reference), (ii) PTrc-2: CCATCGAATGGCTGAAATGAGCTGTTGACAATTAATCATCCGGCTCGTATAATGTGTGGAAT TGTGAGCGGATAACAATTTCACACAGGA (SEQ ID NO: 38) and temperature sensitive promoters such as PLs1con, GCATGCACAGATAACCATCTGCGGTGATAAATTATCTCTGGCGGTGTTGACATAAATACCAC TGGCGGTtATAaTGAGCACATCAGCAGG//GTATGCAAAGGA (SEQ ID NO: 39) and modified variants thereof.

Modification of Engineered Bacteriophages.

In some embodiments of all aspects described herein, an engineered bacteriophage can also be designed for example, for optimal enzyme activity or to delay cell lysis or using multiple phage promoters to allow for increased enzyme production, or targeting multiple biofilm EPS components with different proteins. In some embodiments, one can also target multi-species biofilm with a cocktail of different species-specific engineered enzymatically-active phage, and combination therapy with other agents other than antimicrobial agent that are well known to one skilled in the art and phage to improve the efficacy of both types of treatment.

In some embodiments of all aspects described herein, an engineered bacteriophage can also be used together with other antibacterial or bacteriofilm degrading agents or chemicals such as EGTA, a calcium-specific chelating agent, effected the immediate and substantial detachment of a P. aeruginosa biofilm without affecting microbial activity, NaCl, CaCl₂ or MgCl₂, surfactants and urea.

Phage therapy or bacteriophage therapy has begun to be accepted in industrial and biotechnological settings. For example, the FDA has previously approved the use of phage targeted at Listeria monocytogenes as a food additive. Phage therapy has been used successfully for therapeutic purposes in Eastern Europe for over 60 years. The development and use of phage therapy in clinical settings in Western medicine, in particular for treating mammals such as humans has been delayed due to the lack of properly designed clinical trials to date as well as concerns with (i) development of phage resistance, (ii) phage immunogenicity in the human body and clearance by the reticuloendothelial system (RES), (iii) the release of toxins upon bacterial lysis, and (iv) phage specificity. Many of these concerns are currently being studied and addressed, such as the isolation and development of long-circulating phage that can avoid RES clearance for increased in vivo efficacy. Accordingly, in all aspects described herein, the methods of the present invention are applicable to human treatment as the engineered bacteriophages can be designed to prevent the development of phage resistance in bacteria. A skilled artisan can also develop and carry out an appropriate clinical trial for use in clinical applications, such as therapeutic purposes as well as in human subjects. In some instances, a skilled artisan could establish and set up a clinical trial to establish the specific tolerance of the engineered bacteriophage in human subjects. The inventors have already demonstrated herein that inhibitor-engineered bacteriophage and repressor-engineered bacteriophages and susceptibility-engineered bacteriophages are effective at increasing the efficacy of antimicrobial agents, and are effective in dispersing biofilms, including biofilms present in human organs, such as colon or lungs and other organs in a subject prone to bacterial infection such as bacterial biofilm infection.

Another aspect relates to a pharmaceutical composition comprising at least one engineered bacteriophage and at least one antimicrobial agent. In some embodiments of this and all aspects described herein, the composition can be administered as a co-formulation with one or more other non-antimicrobial or therapeutic agents.

In a further embodiment, the invention provides methods of administration of the compositions and/or pharmaceutical formulations of the invention and include any means commonly known by persons skilled in the art. In some embodiments, the subject is any organism, including for example a mammalian, avian or plant. In some embodiments, the mammalian is a human, a domesticated animal and/or a commercial animal.

While clearance issue is not significant in treatment of chronic diseases, the problem of phage clearance is an important one that needs to be solved as it can make phage therapy more useful for treating transient infections rather than chronic ones. Non-lytic and non-replicative phage have been engineered to kill bacteria while minimizing endotoxin release. Accordingly, the present invention encompasses modification of the inhibitor-engineered and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage with minimal endotoxin release or toxin-free bacteriophage preparation.

The specificity of phage for host bacteria is both an advantage and a disadvantage for phage therapy. Specificity allows human cells as well as innocuous bacteria to be spared, potentially avoiding serious issues such as drug toxicity. Antibiotic therapy is believed to alter the microbial flora in the colon due to lack of target specificity, and in some instances allowing resistant C. difficile to proliferate and cause disease such as diarrhea and colitis. The inhibitor-engineered bacteriophage and repressor-engineered bacteriophages and/or susceptibility engineered bacteriophage as disclosed herein are capable of inhibiting the local bacterial synthetic machinery which normally circumvent antimicrobial effect to result in persistent bacteria.

For host specificity (i.e. bacteria specific inhibitor or repressor-engineered bacteriophages), a well-characterized library of phage must be maintained so that an appropriate inhibitor-engineered bacteriophage or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage therapy can be designed for each individual bacterial infection. The diversity of bacterial infections implies that it may be difficult for any one particular engineered phage to be an effective therapeutic solution for a wide range of biofilms. Accordingly, in one embodiment, the invention provides use of a variety of different engineered bacteriophages in combination (i.e. a cocktail of engineered bacteriophages discussed herein) to cover a range of target bacteria.

One skilled in the art can generate a collection or a library of the inhibitor-engineered bacteriophage and/or repressor engineered bacteriophage and/or susceptibility engineered bacteriophage as disclosed herein by new cost-effective, large-scale DNA sequencing and DNA synthesis technologies. Sequencing technologies allows the characterization of collections of natural phage that have been used in phage typing and phage therapy for many years. Accordingly, a skilled artisan can use synthesis technologies as described herein to add different inhibitors to antibiotic resistance genes or cell survival genes, and/or different repressors to different SOS response genes or non-SOS defense genes or susceptibility agents to produce a variety of new inhibitor-engineered bacteriophage and repressor-engineered bacteriophages and/or susceptibility engineered bacteriophage respectively.

In particular embodiments, the engineered bacteriophages as described herein can be engineered to express an endogenous gene, such as a repressor protein, or a nucleic acid inhibitor of an antibiotic resistance gene or cell survival gene comprising the agent under the control of inducible regulatory elements, in which case the regulatory sequences of the endogenous gene can be replaced by homologous recombination. Gene activation techniques are described in U.S. Pat. No. 5,272,071 to Chappel; U.S. Pat. No. 5,578,461 to Sherwin et al.; PCT/US92/09627 (WO93/09222) by Selden et al.; and PCT/US90/06436 (WO91/06667) by Skoultchi et al, which are all incorporated herein in their entirety by reference.

Furthermore, rational engineering methods with new synthesis technologies can be employed to broaden the engineered bacteriophage host range. For example, T7 can be modified to express K1-5 endosialidase, allowing it to effectively replicate in E. coli that produce the K1 polysaccharide capsule. In some embodiments, the gene 1.2 from phage T3 can be used to extend the bacteriophages as disclosed herein to be able to transfect a host range to include E. coli that contain the F plasmid, thus demonstrating that multiple modifications of a phage genome can be done without significant impairment of the phage's ability to replicate. Bordetella bacteriophage use a reverse-transcriptase-mediated mechanism to produce diversity in host tropism which can also be used according to the methods of the present invention to create a phage that encodes an agent which inhibits antibiotic resistance genes and/or cell survival genes, or alternatively encodes repressors of SOS response genes, and is lytic to the target bacterium or bacteria. The many biofilm-promoting factors required by E. coli K-12 to produce a mature biofilm are likely to be shared among different biofilm-forming bacterial strains and are thus also targets for engineered enzymatic bacteriophage as disclosed herein.

Antimicrobial Agents

One aspect of the present invention relates to the killing or inhibiting the growth of bacteria using a combination of an inhibitor-engineered bacteriophage and/or a repressor engineered bacteriophage and/or a susceptibility engineered bacteriophage with at least one antimicrobial agent. Accordingly, one aspect of the present invention relates to methods and compositions comprising engineered bacteriophages for use in combination with antimicrobial agents to potentiate the antimicrobial effect and bacterial killing function or inhibition of growth function of the antimicrobial agent.

Accordingly in some embodiments of this aspect of the present invention relates to the use of a inhibitor-engineered bacteriophage and/or a repressor engineered bacteriophage and/or susceptibility engineered bacteriophage to potentiate the killing effect of antimicrobial agents. Stated another way, the inhibitor-engineered or repressor-engineered bacteriophage or susceptibility engineered bacteriophage can be used to enhance the efficacy of at least one antimicrobial agent.

An inhibitor-engineered bacteriophages and/or a repressor engineered bacteriophage and/or a susceptibility engineered bacteriophage is considered to potentiate the effectiveness of the antimicrobial agent if the amount of antimicrobial agent used in combination with the engineered bacteriophages as disclosed herein is reduced by at least 10% without adversely affecting the result, for example, without adversely effecting the level of antimicrobial activity. In another embodiment, the criteria used to select inhibitor-engineered bacteriophages and/or a repressor engineered bacteriophage and/or a susceptibility engineered bacteriophage that can potentiate the activity of an antimicrobial agent is an engineered bacteriophage which enables a reduction of at least about 10%, . . . or at least about 15%, . . . or at least about 20%, . . . or at least about 25%, . . . or at least about 35%, . . . or at least about 50%, . . . or at least about 60%, . . . or at least about 90% and all integers inbetween 10-90% of the amount (i.e. dose) of the antimicrobial agent without adversely effecting the antimicrobial effect when compared to the similar amount in the absence of an inhibitor-engineered bacteriophage and/or a repressor engineered bacteriophage and/or a susceptibility engineered bacteriophage.

In some embodiments, any antimicrobial agent can be used which is know by persons of ordinary skill in the art can be used in combination with an inhibitor-engineered bacteriophage or a repressor-engineered bacteriophage and/or a susceptibility engineered bacteriophage. In some embodiments an antimicrobial agent is an antibiotic. Thus, in some embodiments, the engineered bacteriophages as disclosed herein function as antibiotic adjuvants for aminglycoside antimicrobial agents, such as but not limited to, gentamicin, amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin. In some embodiments, the engineered bacteriophages as disclosed herein function as antibiotic adjuvants for β-lactam antibiotics, such as but not limited to, ampicillin, penicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems and β-lactamase inhibitors. In some embodiments, the engineered bacteriophages as disclosed herein function as antibiotic adjuvants for quinolones antimicrobial agents, such as, but not limited to, ofloxacin, ciproflaxacin, levofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, and pazufloxacin.

In alternative embodiments, an antimicrobial agent can be, for example, but not limited to, a small molecule, a peptide, a peptidomimetic, a chemical, a compound and any entity that inhibits the growth and/or kills a microorganism. In some embodiments, an antimicrobial agent can include, but is not limited to; antibodies (polyclonal or monoclonal), neutralizing antibodies, antibody fragments, chimeric antibodies, humanized antibodies, recombinant antibodies, peptides, proteins, peptide-mimetics, aptamers, oligonucleotides, hormones, small molecules, nucleic acids, nucleic acid analogues, carbohydrates or variants thereof that function to inactivate the nucleic acid and/or protein of the gene products identified herein, and those as yet unidentified. Nucleic acids include, for example but not limited to, DNA, RNA, oligonucleotides, peptide nucleic acid (PNA), pseudo-complementary-PNA (pcPNA), locked nucleic acid (LNA), RNAi, microRNAi, siRNA, shRNA etc. The an antimicrobial agent inhibitors can be selected from a group of a chemical, small molecule, chemical entity, nucleic acid sequences, nucleic acid analogues or protein or polypeptide or analogue or fragment thereof.

In some embodiments, an antimicrobial agent is an antimicrobial peptide, for example but not limited to, mefloquine, venturicidin A, antimycin, myxothiazol, stigmatellin, diuron, iodoacetamide, potassium tellurite hydrate, aDL-vinylglycine, N-ethylmaleimide, L-allyglycine, diaryquinoline, betaine aldehyde chloride, acivcin, psicofuraine, buthionine sulfoximine, diaminopemelic acid, 4-phospho-D-erythronhydroxamic acid, motexafin gadolinium and/or xycitrin or modified versions or analogues thereof.

In some embodiments, an antimicrobial agent useful in combination with an inhibitor-engineered or repressor-engineered bacteriophage described herein includes, but are not limited to aminoglycosides, carbapenemes, cephalosporins, cephems, glycoproteins fluoroquinolones/quinolones, oxazolidinones, penicillins, streptogramins, sulfonamides and/or tetracyclines.

Aminoglycosides are a group of antibiotics found to be effective against gram-negative. Aminoglycosides are used to treat complicated urinary tract infections, septicemia, peritonitis and other severe intra-abdominal infections, severe pelvic inflammatory disease, endocarditis, mycobacterium infections, neonatal sepsis, and various ocular infections. They are also frequently used in combination with penicillins and cephalosporins to treat both gram-positive and gram-negative bacteria. Examples of aminoglycosides include amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, and neomycin.

Carbapenems are a class of broad spectrum antibiotics that are used to fight gram-positive, gram-negative, and anaerobic microorganisms. Carbapenems are available for intravenous administration, and as such are used for serious infections which oral drugs are unable to adequately address. For example, carbapenems are often used to treat serious single or mixed bacterial infections, such as lower respiratory tract infections, urinary tract infections, intra-abdominal infections, gynecological and postpartum infections, septicemia, bone and joint infections, skin and skin structure infections, and meningitis. Examples of carbapenems include imipenem/cilastatin sodium, meropenem, ertapenem, and panipenem/betamipron.

Cephalosporins and cephems are broad spectrum antibiotics used to treat gram-positive, gram-negative, and spirochaetal infections. Cephems are considered the next generation Cephalosporins with newer drugs being stronger against gram negative and older drugs better against gram-positive. Cephalosporins and cephems are commonly substituted for penicillin allergies and can be used to treat common urinary tract infections and upper respiratory infections (e.g., pharyugitis and tonsillitis).

Cephalosporins and cephems are also used to treat otitis media, some skin infections, bronchitis, lower respiratory infections (pneumonia), and bone infection (certain; members), and are a preferred antibiotic for surgical prophylaxis. Examples of Cephalosporins include cefixime, cefpodoxime, ceftibuten, cefdinir, cefaclor, cefprozil, loracarbef, cefadroxil, cephalexin, and cephradineze. Examples of cephems include cefepime, cefpirome, cefataxidime pentahydrate, ceftazidime, ceftriaxone, ceftazidime, cefotaxime, cefteram, cefotiam, cefuroxime, cefamandole, cefuroxime axetil, cefotetan, cefazolin sodium, cefazolin, cefalexin.

Fluoroquinolones/quinolones are antibiotics used to treat gram-negative infections, though some newer agents have activity against gram-positive bacteria and anaerobes. Fluoroquinolones/quinolones are often used to treat conditions such as urinary tract infections, sexually transmitted diseases (e.g., gonorrhea, chlamydial urethritis/cervicitis, pelvic inflammatory disease), gram-negative gastrointestinal infections, soft tissue infections, pphthalmic infections, dermatological infections, sinusitis, and respiratory tract infections (e.g., bronchitis, pneumonia, and tuberculosis). Fluoroquinolones/quinolones are used in combination with other antibiotics to treat conditions, such as multi-drug resistant tuberculosis, neutropenic cancer patients with fever, and potentially anthrax. Examples of fluoroquinolones/quinolones include ciproflaxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, and pazufloxacin.

Glycopeptides and streptogramins represent antibiotics that are used to treat bacteria that are resistant to other antibiotics, such as methicillin-resistant staphylococcus aureus (MRSA). They are also be used for patients who are allergic to penicillin Examples of glycopeptides include vancomycin, teicoplanin, and daptomycin.

β-lactam antibiotics are a broad class of antibiotics which include penicillin derivatives, cephalosporins, monobactams, carbapenems and β-lactamase inhibitors; basically, any antibioticor agent or antimicrobial agent which contains a β-lactam nucleus in its molecular structure. Without being bound by theory, β-Lactam antibiotics are bactericidal, and act by inhibiting the synthesis of the peptidoglycan layer of bacterial cell walls. The peptidoglycan layer is important for cell wall structural integrity, especially in Gram-positive organisms. The final transpeptidation step in the synthesis of the peptidoglycan is facilitated by transpeptidases known as penicillin binding proteins (PBPs). β-lactam antibiotics are analogues of D-alanyl-D-alanine—the terminal amino acid residues on the precursor NAM/NAG-peptide subunits of the nascent peptidoglycan layer. The structural similarity between β-lactam antibiotics and D-alanyl-D-alanine facilitates their binding to the active site of penicillin binding proteins (PBPs). The β-lactam nucleus of the molecule irreversibly binds to (acylates) the Ser403 residue of the PBP active site. This irreversible inhibition of the PBPs prevents the final crosslinking (transpeptidation) of the nascent peptidoglycan layer, disrupting cell wall synthesis. Under normal circumstances peptidoglycan precursors signal a reorganization of the bacterial cell wall and consequently trigger the activation of autolytic cell wall hydrolyses. Inhibition of cross-linkage by β-lactams causes a build-up of peptidoglycan precursors which triggers the digestion of existing peptidoglycan by autolytic hydrolases without the production of new peptidoglycan. This as a result further enhances the bactericidal action of β-lactam antibiotics.

Carbapenems are used to treat gram-positive, gram-negative, and/or anaerobes.

Oxazolidinones are commonly administered to treat gram-positive infections. Oxazolidinones are commonly used as an alternative to other antibiotic classes for bacteria that have developed resistance. Examples of oxazolidinones include linezolid.

Penicillins are broad spectrum used to treat gram-positive, gram-negative, and spirochaetal infections. Conditions that are often treated with penicillins include pneumococcal and meningococcal meningitis, dermatological infections, ear infections, respiratory infections, urinary tract infections, acute sinusitis, pneumonia, and Lyme disease. Examples of penicillins include penicillin, amoxicillin, amoxicillin-clavulanate, ampicillin, ticarcillin, piperacillin-tazobactam, carbenicillin, piperacillin, mezocillin, benzathin penicillin G penicillin V potassium, methicillin, nafcillin, oxacillin, cloxacillin, and dicloxacillin.

Streptogramins are antibiotics developed in response to bacterial resistance that diminished effectiveness of existing antibiotics. Streptogramins are a very small class of drugs and are currently very expensive. Examples of streptogramins include quinupristin/dafopristin and pristinamycin.

Sulphonamides are broad spectrum antibiotics that have had reduced usage due to increase in bacterial resistance to them. Sulphonamides are commonly used to treat recurrent attacks of rheumatic fever, urinary tract infections, prevention of infections of the throat and chest, traveler's diarrhea, whooping cough, meningococcal disease, sexually transmitted diseases, toxoplasmosis, and rhinitis. Examples of sulfonamides include co-trimoxazole, sulfamethoxazole trimethoprim, sulfadiazine, sulfadoxine, and trimethoprim.

Tetracyclines are broad spectrum antibiotics that are often used to treat gram-positive, gram-negative, and/or spirochaetal infections. Tetracyclines are often used to treat mixed infections, such as chronic bronchitis and peritonitis, urinary tract infections, rickets, chlamydia, gonorrhea, Lyme disease, and periodontal disease. Tetracyclines are an alternative therapy to penicillin in syphilis treatment and are also used to treat acne and anthrax. Examples of tetracyclines include tetracycline, demeclocycline, minocycline, and doxycycline.

Other antimicrobial agents and antibiotics contemplated herein useful in combination with the engineered bacteriophages as disclosed herein according to the present invention (some of which can be redundant with the list above) include, but are not limited to; abrifam; acrofloxacin; aptecin, amoxicillin plus clavulonic acid; apalcillin; apramycin; astromicin; arbekacin; aspoxicillin; azidozillin; azlocillin; aztreonam; bacitracin; benzathine penicillin; benzylpenicillin; clarithromycin, carbencillin; cefaclor; cefadroxil; cefalexin; cefamandole; cefaparin; cefatrizine; cefazolin; cefbuperazone; cefcapene; cefdinir; cefditoren; cefepime; cefetamet; cefixime; cefinetazole; cefminox; cefoperazone; ceforanide; cefotaxime; cefotetan; cefotiam; cefoxitin; cefpimizole; cefpiramide; cefpodoxime; cefprozil; cefradine; cefroxadine; cefsulodin; ceftazidime; ceftriaxone; cefuroxime; cephalexin; chloramphenicol; chlortetracycline; ciclacillin; cinoxacin; clemizole penicillin; cleocin, cleocin-T, cloxacillin; corifam; daptomycin; daptomycin; demeclocycline; desquinolone; dibekacin; dicloxacillin; dirithromycin; doxycycline; enoxacin; epicillin; ethambutol; gemifloxacin; fenampicin; finamicina; fleroxacin; flomoxef; flucloxacillin; flumequine; flurithromycin; fosfomycin; fosmidomycin; fusidic acid; gatifloxacin; gemifloxaxin; isepamicin; isoniazid; josamycin; kanamycin; kasugamycin; kitasamycin; kalrifam, latamoxef; levofloxacin, levofloxacin; lincomycin; linezolid; lomefloxacin; loracarbaf; lymecycline; mecillinam; methacycline; methicillin; metronidazole; mezlocillin; midecamycin; minocycline; miokamycin; moxifloxacin; nafcillin; nafcillin; nalidixic acid; neomycin; netilmicin; norfloxacin; novobiocin; oflaxacin; oleandomycin; oxacillin; oxolinic acid; oxytetracycline; paromycin; pazufloxacin; pefloxacin; penicillin g; penicillin v; phenethicillin; phenoxymethyl penicillin; pipemidic acid; piperacillin and tazobactam combination; piromidic acid; procaine penicillin; propicillin; pyrimethamine; rifadin; rifabutin; rifamide; rifampin; rifapentene; rifomycin; rimactane, rofact; rokitamycin; rolitetracycline; roxithromycin; rufloxacin; sitafloxacin; sparfloxacin; spectinomycin; spiramycin; sulfadiazine; sulfadoxine; sulfamethoxazole; sisomicin; streptomycin; sulfamethoxazole; sulfisoxazole; quinupristan-dalfopristan; teicoplanin; temocillin; gatifloxacin; tetracycline; tetroxoprim; telithromycin; thiamphenicol; ticarcillin; tigecycline; tobramycin; tosufloxacin; trimethoprim; trimetrexate; trovafloxacin; vancomycin; verdamicin; azithromycin; and linezolid.

Uses of the Engineered Bacteriophages

Accordingly, the inventors have demonstrated that an antimicrobial agent when used in combination with an inhibitor-engineered bacteriophage (which expresses an inhibitor to an antibiotic resistance gene or a cell survival gene) and/or in combination with a repressor-engineered bacteriophage (which expresses at least one repressor to a SOS response gene, or at least one inhibitor or repressor to a non-SOS defense gene) and/or in combination with a susceptibility engineered bacteriophage is effective at killing bacteria, such as a bacterial infection or a bacteria biofilm than use of the antimicrobial alone or the use of the antimicrobial agent used in combination with a non-engineered bacteriophage. The inventors have also discovered that engineered bacteriophages can be adapted to work with a variety of different antimicrobial agents as well as be modified to express other biofilm-degrading enzymes to target a wide range of bacteria and bacteria biofilms. In some embodiments, an antimicrobial agent is used in combination with at least one engineered bacteriophage as disclosed herein, and optionally an addition bacteriophage which is not an inhibitor-engineered or repressor-engineered bacteriophage or a susceptibility engineered bacteriophage, but a bacteriophage which is modified to express a therapeutic gene or a toxin gene or a biofilm degrading gene. Such bacteriophages are well known in the art and are encompassed for use in the methods and compositions as disclosed herein.

Bacterial Infections

One aspect of the present invention relates to the use of the methods and compositions comprising an inhibitor-engineered and/or repressor-engineered bacteriophage and/or a susceptibility engineered bacteriophage in combination with an antimicrobial agent to inhibit the growth and/or kill (or reduce the cell viability) of a microorganism, such as a bacteria. In some embodiments of this aspect and all aspects described herein, a microorganism is a bacterium. In some embodiments, the bacteria are gram positive and gram negative bacteria. In some embodiments, the bacteria are multi-drug resistant bacterium. In further embodiments, the bacteria are polymyxin-resistant bacterium. In some embodiments, the bacterium is a persister bacteria. Examples of gram-negative bacteria are for example, but not limited to P. aeruginosa, A. bumannii, Salmonella spp, Klebsiella pneumonia, Shigeila spp. and/or Stenotrophomonas maltophilia. In one embodiment, the bacteria to be targeted using the phage of the invention include E. coli, S. epidermidis, Yersina pestis and Pseudomonas fluorescens.

In some embodiments, the methods and compositions as disclosed herein can be used to kill or reduce the viability of a bacterium, for example a bacterium such as, but not limited to: Bacillus cereus, Bacillus anbhracis, Bacillus cereus, Bacillus anthracia, Clostridium botulinum, Clostridium difficle, Clostridium tetani, Clostridium perfringens, Corynebacteria diptheriae, Enterococcus (Streptococcus D), Lieteria monocytogenes, Pneumoccoccal infections (Streptococcus pneumoniae), Staphylococcal infections and Streptococcal infections; Gram-negative bacteria including Bacteroides, Bordetella pertussis, Brucella, Campylobacter infections, enterohaemorrhagic Escherichia coli (EHEC/E. coli 0157:17), enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Haemophilus influenzae, Helicobacter pylori, Klebsiella pneumoniae, Legionella spp., Moraxella catarrhalis, Neisseria gonnorrhoeae, Neisseria meningitidis, Proteus spp., Pseudomonas aeruginosa, Salmonella spp., Shigella spp., Vibrio cholera and Yersinia; acid fast bacteria including Mycobacterium tuberculosis, Mycobacterium avium-intracellulars, Myobacterium johnei, Mycobacterium leprae, atypical bacteria, Chlamydia, Myoplasma, Rickettsia, Spirochetes, Treponema pallidum, Borrelia recurrentis, Borrelia burgdorfii and Leptospira icterohemorrhagiae, Actinomyces, Nocardia, P. aeruginosa, A. bumannii, Salmonella spp., Klebsiella pneumonia, Shigeila spp. and/or Stenotrophomonas maltophilia and other miscellaneous bacteria.

Bacterial infections include, but are not limited to, infections caused by Bacillus cereus, Bacillus anbhracis, Bacillus cereus, Bacillus anthracia, Clostridium botulinum, Clostridium difficle, Clostridium tetani, Clostridium perfringens, Corynebacteria diptheriae, Enterococcus (Streptococcus D), Lieteria monocytogenes, Pneumoccoccal infections (Streptococcus pneumoniae), Staphylococcal infections and Streptococcal infections/Gram-negative bacteria including Bacteroides, Bordetella pertussis, Brucella, Campylobacter infections, enterohaemorrhagic Escherichia coli (EHEC/E. coli 0157:17) enteroinvasive Escherichia coli (EIEC), enterotoxigenic Escherichia coli (ETEC), Haemophilus influenzae, Helicobacter pylori, Klebsiella pneumoniae, Legionella spp., Moraxella catarrhalis, Neisseria gonnorrhoeae, Neisseria meningitidis, Proteus spp., Pseudomonas aeruginosa, Salmonella spp., Shigella spp., Vibrio cholera and Yersinia; acid fast bacteria including Mycobacterium tuberculosis, Mycobacterium avium-intracellulars, Myobacterium johnei, Mycobacterium leprae, atypical bacteria, Chlamydia, Myoplasma, Rickettsia, Spirochetes, Treponema pallidum, Borrelia recurrentis, Borrelia burgdorfii and Leptospira icterohemorrhagiae and other miscellaneous bacteria, including Actinomyces and Nocardia.

In some embodiments, the microbial infection is caused by gram-negative bacterium, for example, P. aeruginosa, A. bumannii, Salmonella spp, Klebsiella pneumonia, Shigeila spp. and/or Stenotrophomonas maltophilia. Examples of microbial infections include bacterial wound infections, mucosal infections, enteric infections, septic conditions, pneumonia, trachoma, onithosis, trichomoniasis and salmonellosis, especially in veterinary practice.

Examples of infections caused by P. aeruginosa include: A) Nosocomial infections; 1. Respiratory tract infections in cystic fibrosis patients and mechanically-ventilated patients; 2. Bacteraemia and sepsis; 3, Wound infections, particularly in burn wound patients; 4. Urinary tract infections; 5. Post-surgery infections on invasive devises 5. Endocarditis by intravenous administration of contaminated drug solutions; 7, Infections in patients with acquired immunodeficiency syndrome, cancer chemotherapy, steroid therapy, hematological malignancies, organ transplantation, renal replacement therapy, and other situations with severe neutropenia. B) Community-acquired infections; 1. Community-acquired respiratory tract infections; 2. Meningitis; 3. Folliculitis and infections of the ear canal caused by contaminated waters; 4. Malignant otitis externa in the elderly and diabetics; 5. Osteomyelitis of the caleaneus in children; Eye infections commonly associated with contaminated contact lens; 6. Skin infections such as nail infections in people whose hands are frequently exposed to water; 7. Gastrointestinal tract infections; 8. Muscoskeletal system infections.

Examples of infections caused by A. baumannii include: A) Nosocomial infections 1. Bacteraemia and sepsis, 2. respiratory tract infections in mechanically ventilated patients; 3. Post-surgery infections on invasive devices; 4. wound infectious, particularly in burn wound patients; 5. infection in patients with acquired immunodeficiency syndrome, cancer chemotherapy, steroid therapy, hematological malignancies, organ transplantation, renal replacement therapy, and other situations with severe neutropenia; 6. urinary tract infections; 7. Endocarditis by intravenous administration of contaminated drug solutions; 8. Cellulitis. B) Community-acquired infections; a. community-acquired pulmonary infections; 2. Meningitis; Cheratitis associated with contaminated contact lens; 4. War-zone community-acquired infections. C) Atypical infections: 1. Chronic gastritis.

Examples of infections caused by Stenotrophomonas maltophilia include B acteremia, pneumonia, meningitis, wound infections and urinary tract infections. Some hospital breaks are caused by contaminated disinfectant solutions, respiratory devices, monitoring instruments and ice machines. Infections usually occur in debilitated patients with impaired host defense mechanisms.

Examples of infections caused by Klebsiella pneumoniae include community-acquired primary lobar pneumonia, particularly in people with compromised pulmonary function and alcoholics. It also caused wound infections, soft tissue infections and urinary tract infections.

Examples of infections caused by Salmonella app. are acquired by eating contaminated food products. Infections include enteric fever, enteritis and bacteremia.

Examples of infections caused by Shigella spp. include gastroenteritis (shigellosis).

The methods and compositions as disclosed herein comprising an inhibitor-engineered or repressor-engineered bacteriophage and at least one antimicrobial agent can also be used in various fields as where antiseptic treatment or disinfection of materials it required, for example, surface disinfection.

The methods and compositions as disclosed herein comprising an inhibitor-engineered or repressor-engineered bacteriophage and at least one antimicrobial agent can be used to treat microorganisms infecting a cell, group of cells, or a multi-cellular organism.

In one embodiment, an antimicrobial agent and an engineered bacteriophage as described herein can be used to reduce the rate of proliferation and/or growth of microorganisms. In some embodiments, the microorganism are either or both gram-positive or gram-negative bacteria, whether such bacteria are cocci (spherical), rods, vibrio (comma shaped), or spiral.

Of the cocci bacteria, micrococcus and staphylococcus species are commonly associated with the skin, and Streptococcus species are commonly associated with tooth enamel and contribute to tooth decay. Of the rods family, bacteria Bacillus species produce endospores seen in various stages of development in the photograph and B. cereus cause a relatively mild food poisoning, especially due to reheated fried food. Of the vibrio species, V. cholerae is the most common bacteria and causes cholera, a severe diarrhea disease resulting from a toxin produced by bacterial growth in the gut. Of the spiral bacteria, rhodospirillum and Treponema pallidum are the common species to cause infection (e.g., Treponema pallidum causes syphilis). Spiral bacteria typically grow in shallow anaerobic conditions and can photosynthesize to obtain energy from sunlight.

Moreover, the present invention relates to use of or methods comprising an antimicrobial agent and an engineered bacteriophage as disclosed herein can be used to reduce the rate of growth and/or kill either gram positive, gram negative, or mixed flora bacteria or other microorganisms. In one embodiment, the composition consists essentially of at least one antimicrobial agent and at least one engineered bacteriophage, such as an inhibitor-engineered bacteriophage or repressor-engineered bacteriophage or a susceptibility engineered bacteriophage as disclosed herein for the use to reduce the rate of growth and/or kill either gram positive, gram negative, or mixed flora bacteria or other microorganisms. In another embodiment, the composition contains at least one antimicrobial agent and at least one engineered bacteriophage, such as an inhibitor-engineered bacteriophage or repressor-engineered bacteriophage or a susceptibility engineered bacteriophage as disclosed herein for the use to reduce the rate of growth and/or kill either gram positive, gram negative, or mixed flora bacteria or other microorganisms.

Such bacteria are for example, but are not limited to, listed in Table 7. Further examples of bacteria are, for example but not limited to Baciccis Antracis; Enterococcus faecalis; Corynebacterium; diphtheriae; Escherichia coli; Streptococcus coelicolor; Streptococcus pyogenes; Streptobacillus moniliformis; Streptococcus agalactiae; Streptococcus pneurmoniae; Salmonella typhi; Salmonella paratyphi; Salmonella schottmulleri; Salmonella hirshieldii; Staphylococcus epidermidis; Staphylococcus aureus; Klebsiella pneumoniae; Legionella pneumophila; Helicobacter pylori; Mycoplasma pneumonia; Mycobacterium tuberculosis; Mycobacterium leprae; Yersinia enterocolitica; Yersinia pestis; Vibrio cholerae; Vibrio parahaemolyticus; Rickettsia prowozekii; Rickettsia rickettsii; Rickettsia akari; Clostridium difficile; Clostridium tetani; Clostridium perfringens; Clostridianz novyii; Clostridianz septicum; Clostridium botulinum; Legionella pneumophila; Hemophilus influenzue; Hemophilus parainfluenzue; Hemophilus aegyptus; Chlamydia psittaci; Chlamydia trachonZatis; Bordetella pertcsis; Shigella spp.; Campylobacter jejuni; Proteus spp.; Citrobacter spp.; Enterobacter spp.; Pseudomonas aeruginosa; Propionibacterium spp.; Bacillus anthracia; Pseudomonas syringae; Spirrilum minus; Neisseria meningitidis; Listeria monocytogenes; Neisseria gonorrheae; Treponema pallidum; Francisella tularensis; Brucella spp.; Borrelia recurrentis; Borrelia hennsii; Borrelia turicatue; Borrelia burgdorferi; Mycobacterium avium; Mycobacterium smegmatis; Methicillin-resistant Staphyloccus aureus; Vanomycin-resistant enterococcus; and multi-drug resistant bacteria (e.g., bacteria that are resistant to more than 1, more than 2, more than 3, or more than 4 different drugs).

TABLE 7 Examples of bacteria. Table 7: Examples of Bacteria Staphyloccocus aureus Nisseria menigintidis Helicbacter pylori Bacillus anthracis Nisseria gonerrhoeae Legionella pnemophilia Bacillus cereus Vibrio cholerae Borrelia burgdorferi Bacillus subtillis Escherichia coli K12 Ehrlichia chaffeensis Streptococcus phemonia Bartonella henselae Treponema pallidum Streptococcus pyogenes Haemophilus Chlamydia influenzae trachomatis Clostridium tetani Salmonella typhi Listeria monocytogenes Shigella dysentriae Mycobacterium Yerinisa pestis tuberculosis Staphyloccocus Pseudomona epidermidis aeruginosa

In some embodiments, antimicrobial agent and engineered bacteriophages described herein can be used to treat an already drug resistant bacterial strain such as Methicillin-resistant Staphylococcus aureus (MRSA) or Vancomycin-resistant enterococcus (VRE) of variant strains thereof.

In some embodiments, the present invention also contemplates the use and methods of use of an antimicrobial agent and an engineered bacteriophage as described herein in all combinations with other antimicrobial agents and/or antibiotics to fight gram-positive bacteria that maintain resistance to certain drugs.

In some embodiments, an antimicrobial agents and an engineered bacteriophage as disclosed herein can be used to treat infections, for example bacterial infections and other conditions such as urinary tract infections, ear infections, sinus infections, bacterial infections of the skin, bacterial infections of the lungs, sexually transmitted diseases, tuberculosis, pneumonia, Lyme disease, and Legionnaire's disease. Thus any of the above conditions and other conditions resulting from a microorganism infection, for example a bacterial infection or a biofilm can be prevented or treated by the compositions of the invention herein.

Biofilms

Another aspect of the present invention relates to the use of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or a susceptibility engineered bacteriophage in combination with any antimicrobial agent to eliminate or reduce a bacterial biofilm, for example a bacterial biofilm in a medical, or industrial, or biotechnological setting.

For instance, some bacteria, including P. aeruginosa, actively form tightly arranged multi-cell structures in vivo known as biofilm. The production of biofilm is important for the persistence of infectious processes such as seen in pseudomonal lung-infections in patients with cystic fibrosis and diffuse panbronchiolitis and many other diseases. A biofilm is typically resistant to phagocytosis by host immune cells and the effectiveness of antibiotics at killing bacteria in biofilm structures can be reduced by 10 to 1000 fold. Biofilm production and arrangement is governed by quorum sensing systems. The disruption of the quorum sensing system in bacteria such as P. aeruginosa is an important anti-pathogenic activity as it disrupts the biofilm formation and also inhibits alginate production

Selection of Subjects Administered a Composition Comprising an Engineered Bacteriophage

In some embodiments, a subject amenable for the method described herein or for the administration with a composition comprising at least one antimicrobial agent and an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or a susceptibility engineered bacteriophage is selected based on the desired treatment regime. For instance, a subject is selected for treatment if the subject has a bacterial infection where the bacteria form a biofilm, or where the subject has been non-responsive to prior therapy or administration with an antimicrobial agent.

Accordingly, in some embodiments, a subjects is administered a combination of at least one antimicrobial agent and at least one inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or a susceptibility engineered bacteriophage to potentiate the effect of the antimicrobial agent.

In some embodiments, a subject can be administered a composition comprising at least one antimicrobial agent, for example at least 2, 3, or 4 or as many of 10 different antimicrobial agents and at least one engineered bacteriophage as disclosed herein, for example, for example at least 2, 3, or 4 or as many of 10 different engineered bacteriophages as disclosed herein. In some embodiments, the composition can comprise an antimicrobial agent and at least one or a variety of different repressor-engineered bacteriophages with at least one or a variety of different inhibitor-engineered bacteriophages and/or with at least one or a variety of susceptibility engineered bacteriophages. In alternative embodiments, the composition can comprise at least two, or at least 3, 4, 5 or as many of 10 different inhibitor-engineered bacteriophages, wherein each of the inhibitor-engineered bacteriophages comprise a nucleic acid which encodes at least one inhibitor to a different antibiotic resistance gene and/or cell survival repair gene. In alternative embodiments, the composition can comprise at least two, or at least 3, 4, 5 or as many of 10 different repressor-engineered bacteriophages, wherein each of the repressor-engineered bacteriophages comprise a nucleic acid which encodes at least one repressor to a different SOS response gene and/or at least one repressor or inhibitor to a non-SOS defense gene. Any combination and mixture of antimicrobial agents and mixture of inhibitor-engineered bacteriophages and/or repressor-engineered bacteriophages and/or susceptibility engineered bacteriophages are useful in the compositions and methods of the present invention.

In some embodiments, an antimicrobial agent is administered to a subject at the same time, prior to, or after the administration of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage. In some embodiments, an antimicrobial agent can be formulated to a specific time-release for activity, such as the antimicrobial agent is present in a time-release capsule. In such embodiments, an antimicrobial agent that is formulated for time-release can be administered to a subject at the same time, concurrent with, or prior to, or after the administration of an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage. Methods of formulation of an antimicrobial agent for release in a time-dependent manner are disclosed herein as “sustained release pharmaceutical compositions” in the section entitled “pharmaceutical formulations and compositions.” Accordingly, in such embodiments, a time-release antimicrobial agent can be administered to a subject at the same time (i.e. concurrent with), prior to or after the administration of an engineered bacteriophage independent to the time to which the antimicrobial agent becomes active. In some embodiments, an antimicrobial agent can be administered prior to the administration of the engineered bacteriophage, and the time at which the antimicrobial agent is released from the time-release capsule coincides with the time of the administration of the engineered bacteriophage.

In some embodiments, an antimicrobial agent can be a pro-drug, where it is activated by a second agent. Accordingly, in such embodiments, an antimicrobial pro-drug agent can be administered to a subject at the same time, concurrent with, or prior to, or after the administration of an inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage, and administration of an agent which activates the pro-drug into its active form can be administered the same time, concurrent with, or prior to, or after the administration of the inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage.

In some embodiments, a subject is selected for the administration with the compositions as disclosed herein by identifying a subject that needs a specific treatment regimen of an antimicrobial agent, and is administered an antimicrobial agent concurrently with, or prior to, or after administration with an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage as disclosed herein.

Using a subject with cystic fibrosis as an exemplary example, a subject could be administered an antimicrobial agent to avoid chronic endobronchial infections, such as those caused by pseudomonas aeruginosis or stentrophomonas maltophilia. One such antimicrobial agent which can be used is colistin, however, administration of colistin at the doses and the duration required to efficiently prevent such endobronchial infections in subjects is highly toxic and in some instances fatal. Accordingly, in some embodiments, such a subject selected for a treatment regimen would be administered compositions as disclosed herein comprising an antimicrobial agent and an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage. Thus in such embodiments, an antimicrobial agent can be used at a lower dose when used in combination with an inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage as compared to the use of such an antimicrobial agent alone. Thus one aspect of the invention relates to methods to reduce or decrease the dose of an antimicrobial agent while maintaining efficacy of such an antimicrobial agent, and thus reduce toxic side affects associated with higher doses.

Pharmaceutical Formulations and Compositions

The inhibitor-engineered bacteriophage and repressor-engineered bacteriophages as disclosed herein can be formulated in combination with one or more pharmaceutically acceptable anti-microbial agents. In some embodiments, combinations of different antimicrobial agents can be tailored to be combined with a specific inhibitor-engineered bacteriophage and a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage, where the inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophages and/or susceptibility engineered bacteriophage are designed to target different (or the same) microorganisms or bacteria, which contribute towards morbidity and mortality. A pharmaceutically acceptable composition comprising an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage and an antimicrobial agent as disclosed herein, are suitable for internal administration to an animal, for example human.

In some embodiments, an inhibitor-engineered bacteriophage and/or a repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage as disclosed herein can be used for industrial sterilizing, sterilizing chemicals such as detergents, disinfectants, and ammonium-based chemicals (e.g. quaternary ammonium compounds such as QUATAL, which contains 10.5% N-alkyldimethyl-benzlammonium HCl and 5.5% gluteraldehyde as active ingredients, Ecochimie Ltée, Quebec, Canada), and can be used in concurrently with, or prior to or after the treatment or administration of an antimicrobial agent. Such sterilizing chemicals are typically used in the art for sterilizing industrial work surfaces (e.g. in food processing, or hospital environments), and are not suitable for administration to an animal.

In another aspect of the present invention relates to a pharmaceutical composition comprising an inhibitor-engineered bacteriophage and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage and an antimicrobial agent and a pharmaceutically acceptable excipient. Suitable carriers for the engineered bacteriophages of the invention, and their formulations, are described in Remington's Pharmaceutical Sciences, 16^(th) ed., 1980, Mack Publishing Co., edited by Oslo et al. Typically an appropriate amount of a pharmaceutically acceptable salt is used in the formulation to render the formulation isotonic. Examples of the carrier include buffers such as saline, Ringer's solution and dextrose solution. The pH of the solution is preferably from about 5 to about 8, and more preferably from about 7.4 to about 7.8. Further carriers include sustained release preparations such as semipermeable matrices of solid hydrophobic polymers, which matrices are in the form of shaped articles, e.g. liposomes, films or microparticles. It will be apparent to those of skill in the art that certain carriers can be more preferable depending upon for instance the route of administration and concentration of the an engineered bacteriophage being administered.

Administration to human can be accomplished by means determined by the underlying condition. For example, if the engineered bacteriophage is to be delivered into lungs of an individual, inhalers can be used. If the composition is to be delivered into any part of the gut or colon, coated tablets, suppositories or orally administered liquids, tablets, caplets and so forth can be used. A skilled artisan will be able to determine the appropriate way of administering the phages of the invention in view of the general knowledge and skill in the art.

Compounds as disclosed herein, can be used as a medicament or used to formulate a pharmaceutical composition with one or more of the utilities disclosed herein. They can be administered in vitro to cells in culture, in vivo to cells in the body, or ex vivo to cells outside of a subject that can later be returned to the body of the same subject or another subject. Such cells can be disaggregated or provided as solid tissue in tissue transplantation procedures.

Compositions comprising at least one antimicrobial agent and at least one engineered bacteriophage (i.e. an inhibitor engineered and/or repressor-engineered bacteriophage and/or susceptibility engineered bacteriophage) as disclosed herein can be used to produce a medicament or other pharmaceutical compositions. Use of the compositions as disclosed herein which comprise a combination of at least one antimicrobial agents and an engineered bacteriophage can further comprise a pharmaceutically acceptable carrier. The composition can further comprise other components or agents useful for delivering the composition to a subject are known in the art. Addition of such carriers and other components to the agents as disclosed herein is well within the level of skill in this art.

In some embodiments, the composition is a composition for sterilization of a physical object, that is infected with bacteria, such as sterilization of hospital equipment, industrial equipment, medical devices and food products. In another embodiment, the compositions are a pharmaceutical composition useful to treat a bacterial infection in a subject, for example a human or animal subject.

In some embodiments, a pharmaceutical composition as disclosed herein can be administered as a formulation adapted for passage through the blood-brain barrier or direct contact with the endothelium. In some embodiments, the pharmaceutical compositions can be administered as a formulation adapted for systemic delivery. In some embodiments, the compositions can be administered as a formulation adapted for delivery to specific organs, for example but not limited to the liver, bone marrow, or systemic delivery.

Alternatively, pharmaceutical compositions can be added to the culture medium of cells ex vivo. In addition to the antimicrobial agent and engineered bacteriophages, such compositions can contain pharmaceutically-acceptable carriers and other ingredients or agents known to facilitate administration and/or enhance uptake (e.g., saline, dimethyl sulfoxide, lipid, polymer, affinity-based cell specific-targeting systems). In some embodiments, a pharmaceutical composition can be incorporated in a gel, sponge, or other permeable matrix (e.g., formed as pellets or a disk) and placed in proximity to the endothelium for sustained, local release. The composition can be administered in a single dose or in multiple doses which are administered at different times.

Pharmaceutical compositions can be administered to a subject by any known route. By way of example, the composition can be administered by a mucosal, pulmonary, topical, or other localized or systemic route (e.g., enteral and parenteral). The phrases “parenteral administration” and “administered parenterally” as used herein means modes of administration other than enteral and topical administration, usually by injection, and includes, without limitation, intravenous, intramuscular, intraarterial, intrathecal, intraventricular, intracapsular, intraorbital, intracardiac, intradermal, intraperitoneal, transtracheal, subcutaneous, subcuticular, intraarticular, sub capsular, subarachnoid, intraspinal, intracerebro spinal, and intrasternal injection, infusion and other injection or infusion techniques, without limitation. The phrases “systemic administration,” “administered systemically”, “peripheral administration” and “administered peripherally” as used herein mean the administration of the agents as disclosed herein such that it enters the animal's system and, thus, is subject to metabolism and other like processes, for example, subcutaneous administration.

The phrase “pharmaceutically acceptable” is employed herein to refer to those compounds, materials, compositions, and/or dosage forms which are, within the scope of sound medical judgment, suitable for use in contact with the tissues of human beings and animals without excessive toxicity, irritation, allergic response, or other problem or complication, commensurate with a reasonable benefit/risk ratio.

The phrase “pharmaceutically acceptable carrier” as used herein means a pharmaceutically acceptable material, composition or vehicle, such as a liquid or solid filler, diluent, excipient, solvent or encapsulating material, involved in carrying or transporting the subject agents from one organ, or portion of the body, to another organ, or portion of the body. Each carrier must be “acceptable” in the sense of being compatible with the other ingredients of the formulation, for example the carrier does not decrease the impact of the agent on the treatment. In other words, a carrier is pharmaceutically inert.

Suitable choices in amounts and timing of doses, formulation, and routes of administration can be made with the goals of achieving a favorable response in the subject with a bacterial infection or infection with a microorganism, for example, a favorable response is killing or elimination of the microorganism or bacteria, or control of, or inhibition of growth of the bacterial infection in the subject or a subject at risk thereof (i.e., efficacy), and avoiding undue toxicity or other harm thereto (i.e., safety). Therefore, “effective” refers to such choices that involve routine manipulation of conditions to achieve a desired effect or favorable response.

A bolus of the pharmaceutical composition can be administered to a subject over a short time, such as once a day is a convenient dosing schedule. Alternatively, the effective daily dose can be divided into multiple doses for purposes of administration, for example, two to twelve doses per day. Dosage levels of active ingredients in a pharmaceutical composition can also be varied so as to achieve a transient or sustained concentration of the composition in the subject, especially in and around the area of the bacterial infection or infection with a microorganism, and to result in the desired therapeutic response or protection. It is also within the skill of the art to start doses at levels lower than required to achieve the desired therapeutic effect and to gradually increase the dosage until the desired effect is achieved.

The amount of the pharmaceutical compositions to be administered to a subject is dependent upon factors known to a persons of ordinary skill in the art such as bioactivity and bioavailability of the antimicrobial agent (e.g., half-life in the body, stability, and metabolism of the engineered bacteriophage); chemical properties of the antimicrobial agent (e.g., molecular weight, hydrophobicity, and solubility); route and scheduling of administration, and the like. It will also be understood that the specific dose level of the composition comprising antimicrobial agents and engineered bacteriophages as disclosed herein to be achieved for any particular subject can depend on a variety of factors, including age, gender, health, medical history, weight, combination with one or more other drugs, and severity of disease, and bacterial strain or microorganism the subject is infected with, such as infection with multi-resistant bacterial strains.

The term “treatment”, with respect to treatment of a bacterial infection or bacterial colonization, inter alia, preventing the development of the disease, or altering the course of the disease (for example, but not limited to, slowing the progression of the disease), or reversing a symptom of the disease or reducing one or more symptoms and/or one or more biochemical markers in a subject, preventing one or more symptoms from worsening or progressing, promoting recovery or improving prognosis, and/or preventing disease in a subject who is free therefrom as well as slowing or reducing progression of existing disease.

In some embodiments, efficacy of treatment can be measured as an improvement in morbidity or mortality (e.g., lengthening of survival curve for a selected population). Prophylactic methods (e.g., preventing or reducing the incidence of relapse) are also considered treatment.

Dosages, formulations, dosage volumes, regimens, and methods for analyzing results aimed at reducing the number of viable bacteria and/or activity can vary. Thus, minimum and maximum effective dosages vary depending on the method of administration. Suppression of the clinical changes associated with bacterial infections or infection with a microorganism can occur within a specific dosage range, which, however, varies depending on the organism receiving the dosage, the route of administration, whether the antimicrobial agents are administered in conjunction with the engineered bacteriophages as disclosed herein, and in some embodiments with other co-stimulatory molecules, and the specific regimen administration. For example, in general, nasal administration requires a smaller dosage than oral, enteral, rectal, or vaginal administration.

For oral or enteral formulations for use with the present invention, tablets can be formulated in accordance with conventional procedures employing solid carriers well-known in the art. Capsules employed for oral formulations to be used with the methods of the present invention can be made from any pharmaceutically acceptable material, such as gelatin or cellulose derivatives. Sustained release oral delivery systems and/or enteric coatings for orally administered dosage forms are also contemplated, such as those described in U.S. Pat. No. 4,704,295, “Enteric Film-Coating Compositions,” issued Nov. 3, 1987; U.S. Pat. No. 4,556,552, “Enteric Film-Coating Compositions,” issued Dec. 3, 1985; U.S. Pat. No. 4,309,404, “Sustained Release Pharmaceutical Compositions,” issued Jan. 5, 1982; and U.S. Pat. No. 4,309,406, “Sustained Release Pharmaceutical Compositions,” issued Jan. 5, 1982, which are incorporated herein in their entirety by reference.

Examples of solid carriers include starch, sugar, bentonite, silica, and other commonly used carriers. Further non-limiting examples of carriers and diluents which can be used in the formulations of the present invention include saline, syrup, dextrose, and water.

Practice of the present invention will employ, unless indicated otherwise, conventional techniques of cell biology, cell culture, molecular biology, microbiology, recombinant DNA, protein chemistry, and immunology, which are within the skill of the art. Such techniques are described in the literature. See, for example, Molecular Cloning: A Laboratory Manual, 2nd edition. (Sambrook, Fritsch and Maniatis, eds.), Cold Spring Harbor Laboratory Press, 1989; DNA Cloning, Volumes I and II (D. N. Glover, ed), 1985; Oligonucleotide Synthesis, (M. J. Gait, ed.), 1984; U.S. Pat. No. 4,683,195 (Mullis et al.,); Nucleic Acid Hybridization (B. D. Hames and S. J. Higgins, eds.), 1984; Transcription and Translation (B. D. Hames and S. J. Higgins, eds.), 1984; Culture of Animal Cells (R. I. Freshney, ed). Alan R. Liss, Inc., 1987; Immobilized Cells and Enzymes, IRL Press, 1986; A Practical Guide to Molecular Cloning (B. Perbal), 1984; Methods in Enzymology, Volumes 154 and 155 (Wu et al., eds), Academic Press, New York; Gene Transfer Vectors for Mammalian Cells (J. H. Miller and M. P. Calos, eds.), 1987, Cold Spring Harbor Laboratory; Immunochemical Methods in Cell and Molecular Biology (Mayer and Walker, eds.), Academic Press, London, 1987; Handbook of Experiment Immunology, Volumes I-IV (D. M. Weir and C. C. Blackwell, eds.), 1986; Manipulating the Mouse Embryo, Cold Spring Harbor Laboratory Press, 1986.

In some embodiments of the present invention may be defined in any of the following numbered paragraphs: 1. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene. 2. The bacteriophage of any of paragraph 1, wherein the antibiotic resistance gene is selected from the group comprising cat, vanA or mecD or variants thereof. 3. The bacteriophage of any of paragraphs 1 or 2, wherein the cell survival gene is selected from the group comprising RecA, RecB, RecC, spot, RelA or variants thereof. 4. The bacteriophage of any of paragraphs 1 to 3, wherein the agent is selected from a group comprising, siRNA, antisense nucleic acid, asRNA, RNAi, miRNA and variants thereof. 5. The bacteriophage of any of paragraphs 1 to 4, wherein the agent is an antisense RNA (asRNA). 6. The bacteriophage of any of paragraphs 1 to 5, wherein the bacteriophage comprises a nucleic acid encoding at least two agents that inhibit at least two different cell survival repair genes. 7. The bacteriophage of any of paragraphs 1 to 6, wherein the bacteriophage comprises a nucleic acid encoding at least two agents that inhibit at least two of RecA, RecB or RecC. 8. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and/or bacterial defense gene. 9. The bacteriophage of any of paragraphs 8, wherein the repressor of a SOS response gene is lexA. 10. The bacteriophage of any of paragraphs 8 or 9, wherein the repressor of a defense gene is SoxR. 11. The bacteriophage of any of paragraphs 8 to 10, wherein the repressor is selected from the group consisting of; marR, arcR, fur, crp, icdA or variants or fragments thereof. 12. The bacteriophage any of paragraphs 8 to 11, wherein the bacteriophage comprises a nucleic acid encoding at least two different repressors of at least one SOS response gene. 13. The bacteriophage any of paragraphs 8 to 12, wherein the bacteriophage comprises a nucleic acid encoding at least two different repressors of at least one bacterial defense gene. 14. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent which increases the susceptibility of a bacteria cell to an antimicrobial agent. 15. The bacteriophage of paragraph 14, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent increases the efficacy of the antimicrobial effect of the antimicrobial agent by at least 10%. 16. The bacteriophage any of paragraphs 14 or 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent increases the entry of an antimicrobial agent to a bacterial cell. 17. The bacteriophage of any of paragraphs 14 to 16, wherein the agent which increases the entry of an antimicrobial agent to a bacterial cell is a porin. 18. The bacteriophage of any of paragraphs 14 to 17, wherein the porin is ompF or variants or fragments thereof. 19. The bacteriophage of any of paragraphs 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent is craA or variants or fragments thereof. 20. The bacteriophage of any of paragraphs 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent is craA or variants or fragments thereof. 21. The bacteriophage of any of paragraphs 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent modifies a pathway specifically expressed in a bacterial cell. 22. The bacteriophage of any of paragraphs 14 to 15 or 21, wherein modification is inhibition or activation of a pathway specifically expressed in a bacterial cell. 23. The bacteriophage of any of paragraphs 14 to 15, wherein the agent which increases iron-sulfur clusters in the bacterial cell. 24. The bacteriophage of any of paragraphs 14 to 15, wherein the agent which increases oxidative stress in a bacterial cell or increases hydrozyl radicals in a bacterial cell. 25. The bacteriophage of any of paragraphs 14 to 24, wherein the agent is not substantially toxic a bacterial cell in the absence of an antimicrobial agent. 26. The bacteriophage of any of paragraphs 14 to 25, wherein the agent is not a chemotherapeutic agent or an protein toxin. 27. The bacteriophage of any of paragraphs 14 to 26, wherein the bacteriophage comprises a nucleic acid encoding at least two different proteins which increase the susceptibility of a bacteria cell to an antimicrobial agent. 28. The bacteriophage of any of paragraphs 14 to 27, wherein the proteins are csrA and ompF or variants or fragments thereof. 29. The bacteriophage of any of paragraphs 1 to 28, wherein the bacteriophage is a lysogenic bacteriophage. 30. The bacteriophage of any of paragraphs 1 to 29, wherein the lysogenic bacteriophage is a M13 bacteriophage. 31. The bacteriophage of any of paragraphs 1 to 29, wherein the bacteriophage is a lytic bacteriophage. 32. The bacteriophage of any of paragraphs 1 to 29, or 31 wherein the lytic bacteriophage is a T7 bacteriophage. 33. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene, and (b) at least one antimicrobial agent. 34. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene or a bacterial-defense gene, and (b) at least one antimicrobial agent. 35. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid a encodes at least one agent which increases the susceptibility of a bacteria cell to an antimicrobial agent, and (b) at least one antimicrobial agent. 36. The method of paragraph 33, wherein the bacteriophage is a bacteriophage according to any of paragraphs 1 to 7 or 29-32. 37. The method of paragraph 34, wherein the bacteriophage is a bacteriophage according to any of paragraphs 8 to 13 or 29-32. 38. The method of paragraph 35, wherein the bacteriophage is a bacteriophage according to any of paragraphs 14 to 32. 39. The method of any of paragraphs 33 to 38, wherein the administration of the bacteriophage and the antimicrobial agent occurs simultaneously. 40. The method of any of paragraphs 33 to 38, wherein the administration of the bacteriophage occurs prior to the administration of the antimicrobial agent. 41. The method of any of paragraphs 33 to 38, wherein the administration of the antimicrobial agent occurs prior to the administration of the bacteriophage. 42. The method of any of paragraphs of any of paragraphs 33 to 38, wherein the antimicrobial agent is a quinolone antimicrobial agent. 43. The method of paragraph 33 to 42, wherein the antimicrobial agent is selected from a group consisting of ciproflaxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin or variants or analogues thereof. 44. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is ofloxacin or variants or analogues thereof. 45. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is an aminoglycoside antimicrobial agent. 46. The method of paragraph 45, wherein the antimicrobial agent is selected from a group consisting of amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin or variants or analogues thereof. 47. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is gentamicin or variants or analogues thereof. 48. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is an β-lactam antibiotic antimicrobial agent. 49. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is selected from a group consisting of penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof. 50. The method of any of paragraphs 33 to 38, wherein the antimicrobial agent is ampicillin or variants or analogues thereof. 51. The method of any of paragraphs 33 to 38, wherein the bacteria is present in a subject. 52. The method of any of paragraphs 33 to 51, wherein the subject is a mammal. 53. The method of any of paragraph 33 to 52, wherein the mammal is a human. 54. The method of any of paragraphs 33 to 53, wherein the bacteria is in a biofilm. 55. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene and at least one antimicrobial agent. 56. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene or a antimicrobial defense gene and at least one antimicrobial agent. 57. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one protein which increases the susceptibility of a bacteria cell to an antimicrobial agent and at least one antimicrobial agent. 58. The composition of any of paragraphs 55 to 57, wherein the antimicrobial agent is a quinolone antimicrobial agent, or aminoglycoside antimicrobial agent or β-lactam antimicrobial agent. 59. The composition of any of paragraphs 55 or 58, wherein the bacteriophage is according to any paragraphs 1-7 or 29-32. 60. The composition of paragraphs 56 or 58, wherein the bacteriophage is according to any paragraphs 8 to 13 or 29-32. 61. The composition of paragraphs 57 or 58, wherein the bacteriophage is according to any paragraphs 14 to 32. 62. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene. 63. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response or an antimicrobial defense gene. 64. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one protein which increases the susceptibility of a bacteria cell to an antimicrobial agent and at least one antimicrobial agent. 65. The use of a bacteriophage according to any of paragraphs 1 to 23 in combination with an antimicrobial agent to reduce the number of bacteria as compared to use of the antimicrobial agent alone. 66. The use of any of the paragraphs 62-65, wherein the bacteria is in a biofilm. 67. A combination of at least two bacteriophages of any of paragraphs 1 to 23 with at least one antimicrobial agent. 68. The combination of paragraph 67, wherein the antimicrobial agent is a quinolone antimicrobial agent. 69. The combination of paragraph 67, wherein the antimicrobial agent is selected from a group consisting of ciproflaxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin or variants or analogues thereof. 70. The combination of paragraph 67, wherein the antimicrobial agent is ofloxacin or variants or analogues thereof. 71. The combination of paragraph 67, wherein the antimicrobial agent is an aminoglycoside antimicrobial agent. 72. The combination of paragraph 67, wherein the antimicrobial agent is selected from a group consisting of amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin or variants or analogues thereof. 73. The combination of paragraph 67, wherein the antimicrobial agent is gentamicin or variants or analogues thereof. 74. The combination of paragraph 67, wherein the antimicrobial agent is an β-lactam antibiotic antimicrobial agent. 75. The combination of paragraph 67, wherein the antimicrobial agent is selected from a group consisting of penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof. 76. The combination of paragraph 67, wherein the antimicrobial agent is ampicillin or variants or analogues thereof. 77. The combination of paragraph 67, wherein the composition comprises a combination of any of the antimicrobial agents according to paragraphs 68-76. 78. Use of a bacteriophage of any of claims 1 to 32 with at least one antimicrobial agent. 79. Use of a combination of at least two of any the bacteriophages of claims 1 to 32 with at least one antimicrobial agent. 80. The use of a bacteriophage of claim 78 or 79 or any to claims 1 to 32 to inhibit or eliminate a bacterial infection. 81. The use of a bacteriophage of claim 78 or 79, wherein the bacteria is present in a subject. 82. The use of a bacteriophage of claim 81, wherein the subject is a mammal. 83. The use of a bacteriophage of claim 82, wherein the mammal is a human. 84. The use of a bacteriophage of claim 78 or 79, wherein the bacteria is in a biofilm. 85. Use of a composition of any of claims 55 to 57 to inhibit or eliminate a bacterial infection. 86. The use of the composition of claim 85, wherein the bacteria is present in a subject. 87. The use of the composition of claim 86, wherein the subject is a mammal. 88. The use of the composition of claim 87, wherein the mammal is a human. 89. The use of the composition of claim 85, wherein the bacteria is in a biofilm.

The following Examples are provided to illustrate the present invention, and should not be construed as limiting thereof.

EXAMPLES

The examples presented herein relate to the methods and compositions comprising inhibitor-engineered bacteriophages, repressor-engineered bacteriophages or susceptibility-agent engineered bacteriophages and antimicrobial agents. Throughout this application, various publications are referenced. The disclosures of all of the publications and those references cited within those publications in their entireties are hereby incorporated by reference into this application in order to more fully describe the state of the art to which this invention pertains. The following examples are not intended to limit the scope of the claims to the invention, but are rather intended to be exemplary of certain embodiments. Any variations in the exemplified methods which occur to the skilled artisan are intended to fall within the scope of the present invention.

Methods

Bacterial strains, bacteriophage, and chemicals. E. coli K-12 EMG2 cells, which lack 0 antigens, were obtained from the Yale Coli Genetic Stock Center (CGSC #4401). E. coli RFS289 cells, which contain a gyrA111 mutation rendering them resistant to quinolones, were obtained from the Yale Coli Genetic Stock Center (CGSC #5742). M13mp18 bacteriophage was purchased from New England Biolabs, Inc. (Ipswich, Mass.). E. coli XL-10 cells used for cloning, amplifying phage, and plating phage were obtained from Stratagene (La Jolla, Calif.).

T4 DNA ligase and all restriction enzymes were purchased from New England Biolabs, Inc. (Ipswich, Mass.). PCR reactions were carried out using PCR SUPERMIX HIGH FIDELITY from INVITROGEN (Carlsbad, Calif.) or PHUSION HIGH FIDELITY from New England Biolabs, Inc. (Ipswich, Mass.). Purification of PCR reactions and restriction digests was carried out with the QIAQUICK GEL Extraction or PCR Purification kits (QIAGEN, Valencia, Calif.). Plasmid DNA was isolated using the QIAPREP SPIN Miniprep kit (QIAGEN, Valencia, Calif.). All other chemicals and materials were purchased from Fisher Scientific, Inc. (Hampton, N.H.).

Engineering M13mp18 bacteriophage to target genetic networks. To construct engineered phage, lexA3, soxR, csrA, and ompF genes were first placed under the control of the P_(L)tetO promoter in the pZE11G vector^(50,51). Using PCR with primers 5′ ttatca ggtacc atgAAAGCGT TAACGGCC 3′ (SEQ ID NO: 18) and 5′ atacat aagctt TTACAGCCA GTCGCCG 3′ (SEQ ID NO: 19), lexA3 was cloned between the KpnI and HindIII sites of pZE11G to form pZE11-lexA3. Since soxR has an internal KpnI site, the inventors built a synthetic RBS by sequential PCR using 5′ agaggagaaa ggtacc atgGAAAAGA AATTACCCCG 3′ (SEQ ID NO: 20) and 5′ atacat aagctt TTAGT TTTGTTCATC TTCCAG 3′ (SEQ ID NO: 21) followed by 5′ agtaga gaattc attaaagaggagaaa ggtacc atg 3′ (SEQ ID NO: 22) and 5′ atacat aagctt TTAGT TTTGTTCATC TTCCAG 3′ (SEQ ID NO: 23). The resulting EcoRI-RBS-soxR-HindIII DNA was ligated to an XhoI-P_(L)tetO-EcoRI fragment excised from pZE11G and the entire DNA fragment was ligated into pZE11G between XhoI and HindIII to form pZE11-soxR⁵⁰. Primers for csrA for cloning into pZE11G in between KpnI and HindIII to form pZE11-csrA were 5′ agaggagaaa ggtacc atgCTGATTC TGACTCGT 3′ (SEQ ID NO: 24) and 5′ atacat aagctt TTAGTA ACTGGACTG C TGG 3′ (SEQ ID NO: 25); and for ompF to form pZE11-ompF, 5′ agaggagaaa ggtacc atgATGAAG C GCAATATTCT 3′ (SEQ ID NO: 26) and 5′ atacat aagctt TTAGAACTG GTAAACGATA CC 3′ (SEQ ID NO: 27). To express csrA and ompF simultaneously under the control of P_(L)tetO, we PCR amplified RBS-ompF DNA from pZE11-ompF using 5′ ccagtc aagctt attaaagaggagaaa ggtacc 3′ (SEQ ID NO: 28) and 5′ atacat GGATCC TTAGAACTG GTAAACGATA CC 3′ (SEQ ID NO: 29) and cloned the product in between HindIII and BamHI in pZE11-csrA to form pZE11-csrA-ompF. The resulting plasmids were transformed into E. coli XL-10 cells.

All P_(L)tetO-gene constructs followed by terminator T1 of the rrnB operon and preceded by a stop codon were PCR amplified from the respective pZE11 plasmids with primers 5′ aataca GAGCTC cTAA tccctatcagtgatagagattg 3′ (SEQ ID NO: 30) and 5′ taatct CGATCG tctagggcggcggat 3′ (SEQ ID NO: 31) and cloned into the Sad and PvuI sites of M13mp18 (FIG. 5)^(48,50,51). Resulting phage genomes were transformed into XL-10 cells, mixed with 200 μL overnight XL-10 cells in 3 mL top agar, 1 mM IPTG, and 40 μL of 20 mg/mL X-gal, and poured onto LB agar+chloramphenicol (30 μg/mL) plates for plaque formation and blue-white screening. After overnight incubation of plates at 3TC, white plaques were scraped and placed into 1:10 dilutions of overnight XL-10 cells and grown for 5 hours. Replicative form (RF) M13mp18 DNA was collected by DNA minipreps of the bacterial cultures. All insertions into M13mp18 were verified by PCR and restriction digests of RF DNA. Infective bacteriophage solutions were obtained by centrifuging infected cultures for 5 minutes at 16,100×g and collecting supernatants followed by filtration through Nalgene #190-2520 0.2 μm filters (Nalge Nunc International, Rochester, N.Y.).

Determination of plaque forming units. To obtain plaque forming units, we added serial dilutions of bacteriophage performed in 1×PBS to 200 μL of overnight XL-10 cells in 3 mL top agar, 1 mM IPTG, and 40 μL of 20 mg/mL X-gal, and poured the mixture onto LB agar+chloramphenicol (30 μg/mL) plates. After overnight incubation at 3TC, plaques were counted.

Determination of colony forming units. To obtain CFU counts, 150 μL of relevant cultures were collected, washed with 1× phosphate-buffered saline (PBS), recollected, and resuspended in 150 μL of 1×PBS. Serial dilutions were performed with 1×PBS and sampled on LB agar plates. LB agar plates were incubated at 3TC overnight before counting.

Flow cytometer assay of SOS induction. To monitor M13mp18-lexA3's (φ_(lexA)) suppression of the SOS response (FIG. 10), the inventors used a plasmid containing an SOS-response promoter driving gfp expression in EMG2 cells (P_(L)lexO-gfp)⁴³. After growing 1:500 dilutions of the overnight cells for 2 hours and 15 minutes at 3TC and 300 rpm (model G25 incubator shaker, New Brunswick Scientific), the inventors applied ofloxacin and bacteriophage and treated for 6 hours at 3TC and 300 rpm. Cells were then analyzed for GFP fluorescence using a Becton Dickinson (Franklin Lakes, N.J.) FACS caliber flow cytometer with a 488-nm argon laser and a 515-545 nm emission filter (FL1) at low flow rate. The following photo-multiplier tube (PMT) settings were used for analysis: E00 (FSC), 275 (SSC), and 700 (FL1). Becton Dickinson CALIBRITE Beads were used for instrument calibration. 200,000 cells were collected for each sample and processed with MATLAB (Mathworks, Natick, Mass.).

Ofloxacin killing assay. To determine the adjuvant effect of engineered phage (FIG. 1B, FIG. 3A and FIG. 3D), the inventors grew 1:500 dilutions of overnight EMG2 cells for 3 hours and 30 minutes at 3TC and 300 rpm to late-exponential phase and determined initial CFUs. Then, the inventors added 60 ng/mL ofloxacin by itself or in combination with 10⁸ PFU/mL bacteriophage (unmodified φ_(unmod) or engineered φ_(LexA), φ_(SoxR), φ_(csr), φ_(ompF), or φ_(Csr-ompF) phage) and treated at 37° C. and 300 rpm. At indicated time points, the inventors determined CFUs as described above. Mean killing (Δ log₁₀ (CFU/mL)) was determined by subtracting mean initial log₁₀ (CFU/mL) from mean log₁₀ (CFU/mL) after treatment in order to compare data from different experiments. This protocol was replicated with E. coli RFS289 to determine the ofloxacin-enhancing effect of engineered φ_(lexA3) phage against antibiotic-resistant bacteria (FIG. 2). In addition, viable cell counts were obtained for ofloxacin-free EMG2 cultures, ofloxacin-free EMG2 cultures with φ_(unmod) phage, and ofloxacin-free EMG2 cultures with engineered φ_(lexA3) phage.

Dose response assays. The initial phage inoculation dose response experiments (FIG. 1 c and FIG. 15) were handled using the same protocol as the ofloxacin killing assay except that 60 ng/mL ofloxacin was added with varying concentrations of phage. Cultures were treated for 6 hours before obtaining viable cell counts. The ofloxacin dose response experiments (FIG. 1C) were also obtained using the same protocol as the ofloxacin killing assay except that 10⁸ PFU/mL phage were added with varying concentrations of ofloxacin and viable cell counts were obtained after 6 hours of treatment.

Persister killing assay. The inventors performed a persister killing assay to determine whether engineered phage could help to kill persister cells in a population which survived initial drug treatment without bacteriophage (FIGS. 11 and 16). The inventors first grew 1:500 dilutions of overnight EMG2 for 3 hours and 30 minutes at 3TC and 300 rpm followed by treatment with 200 ng/mL ofloxacin for 3 hours to create a population of surviving bacteria. Then, the inventors added either no phage, 10⁹ PFU/mL control φ_(unmod), or 10⁹ PFU/mL engineered φ_(LexA3) phage. After 3 hours of additional treatment, the inventors collected the samples and assayed for viable cell counts as described above.

Biofilm killing assay. Biofilms were grown using E. coli EMG2 cells according to a previously-reported protocol (Lu and Collins, 2007). Briefly, lids containing plastic pegs (MBEC Physiology and Genetics Assay, Edmonton, Calif.) were placed in 96-well plates containing overnight cells that were diluted 1:200 in 150 μL LB. Plates were then inserted into plastic bags to minimize evaporation and inserted in a Minitron shaker (Infors HT, Bottmingen, Switzerland). After 24 hours of growth at 35° C. and 150 rpm, lids were moved into new 96-well plates with 200 μL LB with or without 10⁸ PFU/mL of bacteriophage. After 12 hours of treatment at 35° C. and 150 rpm, lids were removed, washed three times in 200 μL of 1×PBS, inserted into Nunc #262162 microtiter plates with 150 μL 1×PBS, and sonicated in an Ultrasonics 5510 sonic water bath (Branson, Danbury, Conn.) at 40 kHz for 30 minutes. Serial dilutions, using the resulting 150 μL 1×PBS, were performed on LB plates and viable cell counts were determined. Mean killing (Δ log₁₀ (CFU/mL)) was calculated by subtracting mean log₁₀ (CFU/mL) after 24 hours of growth from mean log₁₀ (CFU/mL) after 12 hours of treatment (FIG. 17 and FIG. 18).

Antibiotic resistance assay. To analyze the effect of subinhibitory concentrations of ofloxacin on the development of antibiotic-resistant mutants, the inventors grew 1:10⁸ dilutions of overnight EMG2 in LB media containing either no ofloxacin (FIG. 4) or 30 ng/mL ofloxacin (FIG. 7). After 12 hours of growth at 3TC and 300 rpm, the inventors split the cells grown in no ofloxacin into 100 uL aliquots with no ofloxacin in 60 wells in 96-well plate format (Costar 3370; Fisher Scientific, Pittsburgh, Pa.). The inventors also split the cells grown in 30 ng/mL ofloxacin into 100 uL aliquots in 60 wells with either no phage and 30 ng/mL ofloxacin (FIG. 7B), φ_(unmod) phage and 30 ng/mL ofloxacin (FIG. 7C), and φ_(lexA3) and 30 ng/mL ofloxacin (FIG. 7D) in 96-well plate format. The inventors placed the 96-well plates in 37° C. and 300 rpm with plastic bags to minimize evaporation. After 12 hours of treatment, the inventors plated cultures from each well on LB agar+100 ng/mL ofloxacin to select for mutants that developed resistance against ofloxacin. To compare results, the inventors plotted histograms of the number of resistant bacteria found in each well in FIGS. 4 and 8.

Gentamicin and ampicillin killing assays. To determine the antibiotic enhancing or adjuvant effect of engineered bacteriophage for gentamicin and ampicillin, the inventors used the same protocol as the ofloxacin killing assay except that the inventors used 10⁹ PFU/mL initial phage inoculations. 5 μg/mL gentamicin and 5 μg/mL ampicillin were used in FIGS. 1D, 1E, 8A and 8B.

Statistical analysis. All CFU data were log₁₀-transformed prior to analysis. For all data points in all experiments, n=3 samples were collected except where noted. Error bars in figures indicate standard error of the mean.

Example 1

The inventors have engineered synthetic bacteriophage to target genetic networks in order to potentiate bacterial killing in combination therapy with antibiotics. The inventors specifically targeted genetic networks in E. coli which are not directly attacked by antibiotics to avoid imposing additional evolutionary pressures for antibiotic resistance. Instead, the inventors chose proteins that are responsible for repairing cellular damage caused by antibiotics, those that control regulatory networks, or those that modulate sensitivity to antibiotics Unlike conventional antibiotics that act by disrupting protein activity, the inventors designed an engineered phage to overexpress target genes, such as repressors and act as effective antibiotic adjuvants.

Bactericidal antibiotics cause hydroxyl radical formation which leads to DNA, protein, and lipid damage and ultimately, cell death⁴⁴. DNA damage induces the SOS response (Miller et al., (2004) Science 305, 1629-1631; Lewin et al., (1989) J. Med. Microbiol. 29, 139-144.), which results in DNA repair (FIG. 1A). It has been shown that bacterial killing by bactericidal antibiotics can be enhanced by knocking out recA and disabling the SOS response (Kohanski et al., (2007) Cell 130). Here, the inventors used an alternative approach and engineered M13mp8 phage to overexpress lexA3, a repressor of the SOS response (Little et al., (1979) Proc Natl Acad Sci USA 76, 6147-51). Overexpression of lexA to suppress the SOS system has been demonstrated to inhibit the emergence of antibiotic resistance (Cirz et al., (2005) in PLoS Biol, p. e17624). The inventors used M13mp18, a modified version of M13 phage, as the substrate since it is a non-lytic filamentous phage and can accommodate DNA insertions into its genome (Figure S1) (Yanisch-Perron et al., (1985) Gene 33, 103-119).

To repress the SOS response, the inventors placed the lexA3 gene under the control of the synthetic PLtetO promoter followed by a synthetic ribosome-binding sequence (RBS) (Kohanski et al., (2007) Cell 130, 797-810; Little et al., (1979) Proc Natl Acad Sci USA 76, 6147-51; Walker G C (1984) Microbiol. Rev. 48, 60-93; Lutz et al., (1997) Nucleic Acids Res 25, 1203-1210.); The inventors named this phage “φ_(lexA3)” (FIG. 1A and Figure S1B) and the unmodified M13mp18 phage φ_(unmod). PLtetO, which is an inducible promoter in the presence of the TetR repressor, is constitutively on in EMG2 cells, which lack TetR. PLtetO was used for convenience in proof-of-concept experiments as described herein and would not necessarily be the promoter of choice in real-world situations. Accordingly, one of ordinary skill in the art can readily substitute the PLtetO promoter with a different inducible or constitutively active or tissue specific promoter of their choice. The inventors confirmed that φ_(lexA3) suppressed the SOS response induced by ofloxacin treatment by monitoring GFP fluorescence in E. coli K-12 EMG2 cells carrying a plasmid with an SOS-responsive promoter driving gfp expression (Figure S2) (Kohanski et al., (2007) Cell 130, 797-810).

To test φ_(lexA3)'s antibiotic-enhancing effect, the inventors obtained time courses for killing of E. coli EMG2 bacteria with phage and/or ofloxacin treatment. The inventors calculated viable cell counts by counting colony-forming units (CFUs) during treatment with no phage or 10⁸ plaque-forming units/mL (PFU/mL) of phage and with no ofloxacin or 60 ng/mL ofloxacin (FIG. 1B). Bacteria exposed only to ofloxacin were reduced by about 1.7 log₁₀ (CFU/mL) after 6 hours of treatment, reflecting the presence of persisters not killed by the drug (FIG. 1B). By 6 hours, φ_(lexA3) improved the bactericidal effect of ofloxacin by 2.7 orders of magnitude compared to unmodified phage φ_(unmod) (˜0.99.8% additional killing) and by over 4.5 orders of magnitude compared to no phage (˜99.998% additional killing) (FIG. 1B). Unmodified phage enhanced ofloxacin's bactericidal effect, which is consistent with previous observations that unmodified filamentous phage augment antibiotic efficacy against Pseudomonas aeruginosa (Hagens et al., (2006) Microb Drug Resist 12, 164-168). Other researchers have noted that M13-infected E. coli exhibited impaired host stress responses to conditions such as acid stress (Karlsson et al., (2005) Can J Microbiol 51, 29-35). While wishing not to be bound by theory, the mechanism by which unmodified filamentous phage can augment antibiotic efficacy is not well characterized but can involve membrane disruption or impaired stress responses. No significant bacterial regrowth was apparent with combination phage and antibiotic treatment up to 12 hours (FIG. 1B) (Hagens et al., (2003) Lett. Appl. Microbiol. 37, 318-23; Hagens et al., (2004) Antimicrob. Agents Chemother. 48, 3817-22; Summers W C (2001) Annu. Rev. Microbiol. 55, 437-451). The inventors confirmed that both φ_(unmod) and φ_(lexA3)replicated significantly during treatment (data not shown).

Example 2

To test whether φ_(lexA3) can act as an antibiotic adjuvant in different situations, the inventors assayed for bacterial killing with varying initial phage inoculation doses (FIG. 15) and varying doses of ofloxacin (FIG. 1C) after 6 hours of treatment, respectively. φ_(lexA3) enhanced ofloxacin's bactericidal activity over a wide range of multiplicity-of infections (MOIs), from 1:1000 to 1:1 (FIG. 15). φ_(lexA3)'s ability to increase killing by ofloxacin at a low MOI reflects rapid replication and infection by M13 phage. For ofloxacin concentrations of 30 ng/mL and higher, φ_(lexA3) resulted in much greater killing compared with no phage or unmodified phage φ_(unmod) (FIG. 1C). Thus, the inventors have demonstrated that φ_(lexA3) is a strong adjuvant for ofloxacin at doses below and above the minimum inhibitory concentration (60 ng/mL, data not shown).

The inventors next determined whether the engineered phage could increase killing by classes of antibiotics other than quinolones. The inventors tested φ_(lexA3)'s antibiotic-enhancing effect for gentamicin, an aminoglycoside, and ampicillin, a β-lactam antibiotic. As demonstrated herein, φ_(lexA3) increased gentamicin's bactericidal action by over 2.5 and 3 orders of magnitude compared with φ_(unmod) and no phage, respectively (FIG. 1D). φ_(lexA3) also improved ampicillin's bactericidal effect by over 2 and 5.5 orders of magnitude compared with φ_(unmod) and no phage, respectively (FIG. 1E). For both gentamicin and ampicillin, φ_(lexA3)'s strong antibiotic-enhancing effect was noticeable after 1 hour of treatment (FIGS. 1D and 1E). These results are consistent with previous observations that ΔrecA mutants exhibit increased susceptibility to quinolones, aminoglycosides, and β-lactams (Kohanski et al., (2007) Cell 130, 797-810), and demonstrate that engineered phages, such as φ_(lexA3), can act as general adjuvants for the three major classes of bactericidal drugs. The inventors also found that engineered phage φ_(lexA3) is capable of reducing the number of persister cells in populations already exposed to antibiotics as well as enhancing antibiotic efficacy against bacteria living in biofilms. For example, φ_(lexA3) added to a population previously treated only with ofloxacin increased the killing of bacteria that survived the initial treatment by approximately 1 and 1.5 orders of magnitude compared with φ_(unmod) and no phage, respectively (FIG. 16). In addition, simultaneous application of φ_(lexA3) and ofloxacin improved killing of biofilm cells by about 1.5 and 2 orders of magnitude compared with φ_(unmod) plus ofloxacin and no phage plus ofloxacin, respectively (FIG. 17).

Since the inventors previous experiments all involved simultaneous application of bacteriophage and drug, the inventors tested whether later addition of engineered φ_(lexA3) to a previously drug-treated population would also enhance killing Late exponential-phase cells were first exposed to 3 hours of treatment by ofloxacin to generate a population of surviving cells and followed by either no phage, 10⁹ PFU/mL φ_(unmod), or 10⁹ PFU/mL engineered φ_(lexA3) phage. After 3 hours of additional treatment, φ_(lexA3) increased killing by 0.94 log₁₀ (CFU/mL) compared with φ_(unmod) and by over 1.3 log₁₀ (CFU/mL) compared with no phage (FIG. 11). These results indicate that engineered φ_(lexA3) bacteriophage increases the killing of bacteria which survive initial antibiotic treatment and reduce the number of persister cells in a given population.

Example 3

Enhancing Killing of Antibiotic-Resistant Bacteria. In addition to killing wild-type bacteria with increased efficacy, the inventors also demonstrate that the engineered phage can enhance killing of bacteria that have already acquired antibiotic resistance. The inventors applied φ_(lexA3) with ofloxacin against E. coli RFS289, which carries a mutation (gyrA111) that renders it resistant to quinolone antibiotics (Dwyer et al., (2007) Mol Syst Biol 3,917; Schleif R (1972) Proc Natl Acad Sci USA 69, 3479-84). φ_(lexA3) increased the bactericidal action of ofloxacin by over 2 and 3.5 orders of magnitude compared with φ_(unmod) and no phage, respectively (FIG. 2). These results demonstrate that antibiotic-enhancing phage, such as φ_(lexA3) can be used to combat antibiotic-resistant bacteria and therefore can have the potential to bring defunct antibiotics back into clinical use.

Example 4

Increasing Survival of Mice Infected with Bacteria. To determine the clinical relevance of antibiotic-enhancing phage in vivo, the inventors applied the engineered phage φ_(lexA3) with ofloxacin to prevent death in mice infected with bacteria. Mice were injected with E. coli EMG2 intraperitoneally 1 hour prior to receiving different intravenous treatments (FIG. 3A). Eighty percent of mice that received φ_(lexA3) with ofloxacin survived, compared with 50% and 20% for mice that received φ_(unmod) plus ofloxacin or ofloxacin alone, respectively (FIG. 3B). The inventors have demonstrated that the engineered phage φ_(lexA3) with ofloxacin prevents death in vivo of mice with a severe bacterial infection, thus demonstrating that the in vivo efficacy of the antibiotic enhancing phages are effective at rescuing infected mice from death, and demonstrates the feasibility of various embodiments of the invention for clinical use.

Example 5

Reducing the Development of Antibiotic Resistance. Exposure to subinhibitory concentrations of antibiotics can lead to initial mutations which confer low-level antibiotic resistance and eventually more mutations that yield high-level resistance (Martinez et al., (2000) Antimicrob. Agents Chemother. 44, 1771-77). The inventors assessed if the engineered phage, as antibiotic adjuvants, could reduce the number of antibiotic-resistant mutants that result from a bacterial population exposed to antimicrobial drugs. To test this, the inventors grew E. coli EMG2 in media with either no ofloxacin for 24 hours, 30 ng/mL ofloxacin for 24 hours, 30 ng/mL ofloxacin for 12 hours followed by φ_(unmod) plus ofloxacin treatment for 12 hours, or 30 ng/mL ofloxacin for 12 hours followed by φ_(lexA3) plus ofloxacin treatment for 12 hours (FIG. 4). Then, the inventors counted the number of mutants resistant to 100 ng/mL ofloxacin for each of the 60 samples under each growth condition. Growth in the absence of ofloxacin yielded very few resistant cells (median=1) (FIG. 4). However, growth with subinhibitory levels of ofloxacin produced a high number of antibiotic-resistant bacteria (median=1592) (FIG. 4). Treatment with unmodified phage φ_(unmod) decreased the number of resistant cells (median=43.5); however, all samples contained >1 resistant CFU and over half of the samples had >20 resistant CFUs (FIG. 4). In contrast, φ_(lexA3) treatment dramatically suppressed the level of antibiotic-resistant cells (median=2.5), resulting in a majority of samples with either no resistant CFUs or <20 resistant CFUs (FIG. 4).

Example 6

Flexible Targeting of Other Gene Networks. The inventors next demonstrated that the phage platform can be used to target many different gene networks to produce effective antibiotic adjuvants. To demonstrate this, the inventors engineered phage to express proteins that regulate non-SOS gene networks (e.g., SoxR and CsrA) or modulate sensitivity to antibiotics (e.g., OmpF) (FIG. 5 and FIG. 9F) (Lutz et al., (1997) Nucleic Acids Res 25, 1203-10). For example, the soxR-soxS regulon controls a coordinated cellular response to superoxide (Hidalgo et al., (1997) Cell 88, 121-129). SoxR contains a 12Fe-251 cluster that must be oxidized for it to stimulate SoxS production, which then controls the transcription of downstream genes that respond to oxidative stress (Hidalgo et al., (1997) Cell 88, 121-129). As quinolones generate superoxide-based oxidative attack (Dwyer et al., (2007) Mol Syst Biol 3, 91; Kohanski et al., (2007) Cell 130, 797-810), the inventors engineered phage to overexpress wild-type SoxR (φ_(soxR)) to affect this response and improve ofloxacin's bactericidal activity (FIG. 5A). As shown in FIG. 5B, φ_(soxR) enhanced killing by ofloxacin compared with unmodified phage φ_(unmod) and no phage (FIG. 5B). The inventors discovered that the overexpression of SoxR may provide additional iron-sulfur clusters that could be destabilized to increase sensitivity to bactericidal antibiotics (Dwyer et al., (2007) Mol Syst Biol 3, 91; Kohanski et al., (2007) Cell 130, 797-810). Alternatively, since SoxR is usually kept at relatively levels in vivo which are unchanged by oxidative stress (Hidalgo et al., (1998) EMBO J. 17, 2629-2636), and the overexpression of large amounts of SoxR may interfere with signal transduction in response to oxidative stress by titrating intracellular iron or oxidizing species or by competing with oxidized SoxR for binding to the soxS promoter (Hidalgo et al., (1998) EMBO J. 17, 2629-36; Meng M et al., (1999) J Bacteriol 181, 4639-4643; Gaudu et al., (1996) Proc Natl Acad Sci USA 93, 10094-98).

CsrA is a global regulator of glycogen synthesis and catabolism, gluconeogenesis, and glycolysis, and has been shown to represses biofilm formation (Jackson D W et al., (2002) J. Bacteriol. 184, 290-301). As biofilm formation has been linked to antibiotic resistance, the inventors assessed if csrA-expressing phage (φ_(csrA)) would increase susceptibility to antibiotic treatment (Stewart et al., (2001) Lancet 358, 135-138). In addition, since OmpF is a porin used by quinolones to enter bacteria (Hirai et al., (1986) Antimicrob. Agents Chemother. 29, 535-538), the inventors also assessed if ompF-expressing phage (φ_(ompF)) would increase killing by ofloxacin (FIG. 5C). After 6 hours, both φ_(csrA) and φ_(ompF) increased ofloxacin's bactericidal effect by approximately 1 and 3 orders of magnitude compared with φ_(unmod) and no phage, respectively (FIG. 5D).

Example 7

Systems biology analysis often results in the identification of multiple antibacterial targets which are not easily addressed by traditional drug compounds. In contrast, engineered phage are well-suited for incorporating multiple targets into a single antibiotic adjuvant. To demonstrate this capability, the inventors designed an M13mp18 phage to express csrA and ompF simultaneously (φ_(csrA-ompF)) to target csrA-controlled gene networks and increase drug penetration (FIG. 5C). The multi-target phage was constructed by placing RBS and ompF immediately downstream of csrA in φ_(csrA) (FIG. 9F) (Lutz et al., (1997) Nucleic Acids Res 25, 1203-1210). The inventors demonstrated that φ_(csrA-ompF) was more effective at enhancing ofloxacin's bactericidal effect compared with its single-target relatives, φ_(csrA) and φ_(ompF), in planktonic (FIG. 5D) and biofilm settings (FIG. 18). Together, these results demonstrate that engineering phage to target non-SOS genetic networks such as networks which increase a bacterial cells susceptibility to an antimicrobial agent and/or overexpress multiple factors can produce effective antibiotic adjuvants.

Example 8

To show that other targets can be found to enhance the efficacy of combination therapy with bacteriophage and antibiotic, the inventors screened M13mp18 bacteriophage which expressed proteins that could modulate sensitivity to antibiotics or that control regulatory networks, such as soxR, fur, crp, marR, icdA, csrA, and ompF. The inventors did this by obtaining viable cell counts after 6 hours of treatment with ofloxacin. Phage expressing soxR, csrA, or ompF yielded the greatest improvements in killing by ofloxacin (See FIG. 1). Like φ_(LexA3), these phage expressed their respective proteins under the control of P_(L)tetO and a synthetic RBS (FIGS. 9C, 9D, and 9E)⁵⁰. Since SoxR regulates a cellular response to superoxide stress and quinolones stimulate superoxide-based oxidative attack, the inventors surmised that overproducing SoxR could affect this response and improve ofloxacin's bactericidal activity^(43,52). As shown in FIG. 6A, soxR-expressing M13mp18 (φ_(SoxR)) enhanced killing by ofloxacin by about 3.8 log₁₀ (CFU/mL) compared with no phage and by about 1.9 log₁₀ (CFU/mL) compared with unmodified φ_(unmod) after 6 hours of treatment.

CsrA is a global regulator of glycogen synthesis and catabolism, gluconeogenesis, glycolysis, and biofilm formation⁵³. Since biofilm formation has been linked to antibiotic resistance, the inventors assessed if overexpressing csrA might increase susceptibility to antibiotic treatment⁵⁴⁻⁵⁶. OmpF is a porin which is used by quinolones to enter bacteria and therefore, the inventors determined that overproducing OmpF would increase killing by ofloxacin⁵⁷. The inventors discovered that csrA-expressing M13mp18 (φ_(csrA)) and ompF-expressing M13mp18 (φ_(ompF)) both increased ofloxacin's bactericidal effect by about 2.7 log₁₀ (CFU/mL) compared with no phage and 0.8 log₁₀ (CFU/mL) compared with unmodified φ_(unmod) after 6 hours of treatment (FIG. 6B).

In order to enhance the effectiveness of engineered phage with csrA or ompF alone as antibiotic adjuvants, the inventors designed an M13mp18 phage to express csrA and ompF simultaneously (φ_(csrA-ompF)) (FIG. 9F). The combination phage was constructed by modifying φ_(csrA) to carry an RBS and ompF immediately downstream of csrA⁵⁰. φ_(csrA-ompF) improved killing by ofloxacin by over 0.7 log₁₀ (CFU/mL) compared with φ_(csrA) and φ_(ompF) after 6 hours of treatment (FIG. 6B). The dual-target φ_(csrA)-ompF phage performed comparably with φ_(SoxR) at various initial phage inoculations with 60 ng/mL ofloxacin (FIG. 6C) and at various concentrations of ofloxacin with 10⁸ PFU/mL phage (FIG. 6D). Both phages were more effective than no phage or φ_(unmod) at increasing killing by ofloxacin. These results demonstrate that targeting other non-SOS genetic networks and overexpressing multiple factors, i.e. multiple repressors can result in engineered bacteriophage which are good adjuvants for antibiotics.

Exposure to subinhibitory concentrations of antibiotics can lead to initial mutations which confer low-level antibiotic resistance and eventually more mutations that yield high-level antibiotic resistance¹⁷. By enhancing ofloxacin's bactericidal effect, engineered bacteriophage can reduce the number of antibiotic-resistant mutants that survive in a bacterial population exposed to antimicrobial drugs. To demonstrate this effect, the inventors grew E. coli in media with no ofloxacin (FIG. 7A) or 30 ng/mL ofloxacin for 12 hours (FIG. 7B, FIG. 7C, and FIG. 7D) to produce antibiotic-resistant mutants. Then, the inventors divided the cells which grew under no ofloxacin into 60 individual wells with no ofloxacin (FIG. 7A). The inventors also divided the cells which grew under 30 ng/mL ofloxacin into 60 individual wells for each of the following treatments: no phage and 30 ng/mL ofloxacin (FIG. 7B), 10⁹ PFU/mL φ_(unmod) and 30 ng/mL ofloxacin (FIG. 7C), and 10⁹ PFU/mL φ_(lexA3) with 30 ng/mL ofloxacin (FIG. 7D). After 12 hours of additional growth, the inventors determined the number of antibiotic-resistant mutants by plating and counting the number of cells that grew on LB agar containing 100 ng/mL ofloxacin. FIG. 7A shows that growth in the absence of ofloxacin yielded very few resistant cells. However, growth in the presence of a subinhibitory level of ofloxacin resulted in a very high number of antibiotic-resistant bacteria (FIG. 7B). Although treatment with φ_(unmod) reduced the number of resistant cells, all of the 60 individual wells tested contained at least one resistant CFU and over half of the wells had more than 20 resistant CFUs (FIG. 7C). In contrast to treatment with no phage or unmodified φ_(unmod), φ_(lexA3) treatment suppressed the level of resistant cells dramatically, resulting in a majority of wells with either no observable resistant CFUs or less than 20 CFUs (FIG. 3 d). These results demonstrate that engineered φ_(lexA3) is efficacious at reducing the number of antibiotic-resistant cells which can develop in the presence of subinhibitory drug concentrations.

Example 9

The inventors also sought to determine whether the engineered phage could be applied to different classes of antibiotics other than the quinolones. Since φ_(lexA3) was the most effective adjuvant for ofloxacin, the inventors tested its adjuvant effect for gentamicin, an aminoglycoside, and ampicillin, a β-lactam antibiotic. For 5 μg/mL gentamicin, φ_(unmod) was slightly more effective at enhancing killing of bacterial cells by ofloxacin compared with no phage (FIG. 8A). φ_(lexA3) increased gentamicin's bactericidal action by over 2.5 log₁₀ (CFU/mL) compared with φ_(unmod) and by over 3 log₁₀ (CFU/mL) compared with no phage after 6 hours of treatment (FIG. 8A). For 5 μg/mL ampicillin, control φ_(unmod) alone increased killing by ofloxacin by more than 3 orders of magnitude compared to no phage (FIG. 4 b). φ_(lexA3) improved ampicillin's bactericidal effect by over 2.2 log₁₀ (CFU/mL) compared with unmodified φ_(unmod) and by over 5.5 log₁₀ (CFU/mL) compared to no phage (FIG. 8B). For both gentamicin and ampicillin, φ_(lexA3)'s strong adjuvant effect was noticeable after 1 hour of treatment (FIG. 8A and FIG. 8B). These results are consistent with previous observations that ΔrecA mutants exhibit increased susceptibility to quinolone, aminoglycoside, and β-lactam drugs⁴⁴. Therefore, engineered bacteriophage such as φ_(lexA3) can act as general adjuvants for the three major classes of bactericidal drugs.

Using phage, the inventors have demonstrated that targeting genetic networks to potentiate killing by existing antimicrobial drugs is a highly effective strategy for enhancing the usefulness of antibiotics. The host specificity of phage avoids the side effects associated with broad-spectrum antibiotics such as Clostridium difficile overgrowth but requires a library of phage to be maintained to cover a range of infections^(58,59).

In some embodiments, libraries of existing phage could be modified to overexpress other genes, such as for example but not limited to lexA3 to suppress the SOS response in different bacterial species^(60,61).

Example 10

A direct method of attacking antibiotic-resistant bacteria is to express asRNAs to knockdown genes that either confer antibiotic resistance or promote cell repair and the SOS response. Thus, the inventors expressed an antisense RNA (asRNAs) against the cat gene and other antibiotic-resistance genes (genes that inactivate antibiotics or pump out antibiotics or genetic circuits that confer persistence or any other antibiotic resistance phenotype such as vanA, mecA, and others) as well as recA, recB, recC, spoT, relA, and other genes necessary for cell repair or survival. These vectors should sensitize cells to antibiotics since they will target genes that inactivate or pump out antibiotics and those that are necessary for cell repair from damage caused by antibiotics (Dwyer et al., (2007) Mol Syst Biol 3: 91). Inhibiting the SOS response may also reduce the spread of antibiotic resistance genes (Beaber, et al., (2004) Nature 427: 72-74; Ubeda, et al., (2005) Mol Microbiol 56: 836-844).

The designs that have been currently experimented with extend the paired-termini (PT7) design described in Nakashima et al., (2006) Nucleic Acids Res 34: e138, which produces an RNA similar to that shown in FIG. 12. The PT7 construct produces antisense RNA with longer half-lives in vivo, allowing for greater antisense effect (Nakashima et al., (2006) Nucleic Acids Res 34: e138). Using the PT system, we have constructed antisense RNAs targeting cat, recA, recB, and recC (Nakashima et al., (2006) Nucleic Acids Res 34: e138). These asRNA constructs have been placed under inducible control by aTc by cloning into pZE21s1-cat in place of cat (Lutz et al., (1997) Nucleic Acids Res 25: 1203-1210). The inventors also created all pairwise combinations of asRNAs to recA, recB, and recC by placing one asRNA construct under the control of P_(L)tetO and the other under the control of P_(L)lacO on the same plasmid (Lutz et al., (1997) Nucleic Acids Res 25: 1203-1210).

All the plasmids described thereafter have been introduced into wild-type E. coli EMG2 cells and have been assayed for survival with antibiotic treatment. All cells and suitable controls were grown for 8 hours at 37° C. in LB media (with appropriate inducers) and challenged with antibiotics such as ofloxacin at 5 μg/mL. Cell counts were plated after 8 hours of exposure to antibiotic and counted to assess persistence levels. Cells will also be assayed for resistance to specific antibiotics (for example, chloramphenicol in the presence of cat-expressing plasmids).

The inventors constructed asRNA targeting cat and have expressed the asRNA in a ColE1-type plasmid. With the cat-asRNA vector, the inventors assessed if the chloramphenicol MIC of target bacteria is effectively reduced. The inventors constructed vectors with recA-asRNA, recB-asRNA, recC-asRNA and all pairwise recA, recB, and recC combinations and assayed for persistence levels with ofloxacin (5 μg/mL) with 8 hours of growth followed by 8 hours of treatment. The vectors which demonstrated the strongest phenotypes were the P_(L)tetO-recB-asRNA/P_(L)lacO-recA-asRNA and P_(L)tetO-recC-asRNA/P_(L)lacO-recB-asRNA plasmids (FIG. 14). These constructs displayed 1.87 and 2.37 log₁₀ (CFU/mL) less persisters, respectively, compared with wild-type E. coli EMG2.

Example 11

The inventors have demonstrated herein that combination therapy which couples antibiotics with antibiotic-enhancing phage has the potential to be an effective antimicrobial strategy. Moreover, the inventors have demonstrated that antibiotic-enhancing phage are effective in vivo in rescuing bacterially infected mice, and thus have clinical relevance for their use in vivo, in mammalian models of bacterial infections, as well as in human treatment, both for therapeutic and prophylactic treatment. Thus, the inventors have demonstrated a method to modify phage (i.e. bacteriophage) to be engineered to act as effective antibiotic adjuvants in vitro and in vivo and can be used in methods for antimicrobial target identification as well as for therapeutic use and implementation. The inventors have also demonstrated that by targeting non-essential gene networks, a diverse set of engineered bacteriophage can be developed to supplement other antimicrobial strategies.

While use of phages in clinical practice is not widely accepted due to a number of issues such as phage immunogenicity, efficacy, target bacteria identification and phage selection, host specificity, and toxin release (Merril et al., (2003) Nat. Rev. Drug Discov. 2, 489-497; Hagens et al., (2003) Lett. Appl. Microbiol. 37, 318-323; Hagens et al., (2004) Antimicrob. Agents Chemother. 48, 3817-3822; Boratynski et al., (2004) Cell. Mol. Biol. Lett. 9, 253-259; Merril et al., (1996) Proc Natl Acad Sci USA 93, 3188-3192), the inventors indicate that one way to reduce the risk of leaving lysogenic particles in patients after treatment, the inventors engineered adjuvant phages could be further modified to be non-replicative, as has been previously described (Hagens et al., (2004) Antimicrob 11). The inventors have demonstrated an antibiotic-enhancing phage as a prototype phage as proof of-concept antibiotic adjuvants. The inventors indicate that in some embodiments, a combination of antibiotic-enhancing phages or phage cocktails can be used for in vivo and in vitro use, as well as in clinical settings for effective efficacy and/or the ability to treat non-F-plasmid containing bacteria. In particular, in some embodiments phage cocktails which target different, multiple bacterial receptors can be used, which can have a benefit of reducing the development of phage resistance by invading bacteria through multiple different means and pathways. Thus, in another embodiment, phage cocktails can be used with one or more different antibiotics to also enhance bacterial killing as well as reduce resistance to both the phages and antibiotics.

The inventors have demonstrated use of engineered antibiotic-enhancing phages as a phage platform for the development of effective antibiotic adjuvants, and is a practical example of how synthetic biology can be applied to important real-world biomedical issues. Synthetic biology is focused on the rational and modular engineering of organisms to create novel behaviors. The field has produced many reports of synthetic gene circuits and systems with interesting characteristics (Andrianantoandro et al., (2006) Mol Syst Biol, 2, 2006.0028; Hasty et al., (2002) in Nature, pp. 224-230; McDaniel et al., (2005) in Curr. Opin. Biotechnol., pp. 476-483.; Chan et al., (2005) in Mol Syst Biol, p. 2005.0018). More recently, synthetic biologists have begun to address important industrial and medical problems (Lu et al., (2007) Proc Natl Acad Sci USA 104, 11197-216; Anderson et al., (2006) J. Mol. Biol. 355, 619-627; Loose et al., (2006) Nature 443, 867-869; Ro et al, (2006) Nature 440, 940-943).

In some embodiments, the present invention also encompasses production and use of libraries of natural phage which have been modified to target gene networks and pathways, such as the SOS response, in different bacterial species (Hickman-Brenner et al., (1991) J. Clin. Microbiol. 29, 2817-2823). One of ordinary skill in the art could generate and use such libraries by using routine methods in the art, such as isolation and genetic modification of natural phage with the ability to infect the bacterial species being targeted. With current DNA sequencing and synthesis technology, an entire engineered bacteriophage genome carrying multiple constructs to target different gene networks could be synthesized (Baker et al, (2006) Sci. Am. 294, 44-51). Thus, one of ordinary skill in the art, using such technologies could carry out large-scale modifications of phage libraries to produce antibiotic-enhancing phage that can be applied with different antibiotic drugs against a wide range of bacterial infections. Targeting clinical bacterial strains with libraries of engineered phage, which can be carried out by routine testing by one of ordinary skill in the art to identify which engineered phage from the libraries is effective as an antibiotic-enhancing phage to clinically relevant bacterial strains and has important uses in developing treatments against real-world infections.

In some embodiments, the engineered phages as described herein can also be used in industrial, agricultural, and food processing settings where bacterial biofilms and other difficult-to-clear bacteria are present (Lu et al., (2007) Proc Natl Acad Sci USA 104, 11197-216). Accordingly, some embodiments as described herein encompass applying the engineered phage as described herein as antibiotic adjuvants in non-medical settings. This could be economically advantageous, reduce community-acquired antibiotic resistance, and be also be useful in testing efficacy of the particular engineered phage prior to its use as a treatment and/or in clinical use (Morens et al., (2004) Nature 430, 242-24949).

Another strategy to combat antibiotic resistance is to take advantage of the numerous autoregulated repressors inherent in bacteria that regulate resistance genes or cell repair pathways (Okusu, et al., (1996) J Bacteriol 178: 306-308). For example, lexA represses the SOS response until it is cleaved by recA in response to DNA damage (Dwyer et al., (2007) Mol Syst Biol 3: 91). In addition, marR represses the marRAB operon and acrR represses the acrAB operon; both operons confer resistance to a range of antibiotics (Okusu, et al., (1996) J Bacteriol 178: 306-308). To increase repression of the SOS response or antibiotic-resistance-conferring operons, we propose to overexpress the responsible repressors. However, simple overexpression may impose a high metabolic cost on the cells leading to rejection of the introduced constructs. Therefore, as an alternative to simple overexpression, the inventors created an autoregulated negative-feedback modules with lexA and other repressors and determine whether cells are sensitized to antibiotic treatment with these constructs (FIG. 13). The net effect of this strategy should be to increase the loop gain of inherent autoregulated negative-feedback loops so that any perturbations in the level of repressors will be more rapidly restored, hopefully preventing successful activation of survival pathways.

The inventors produced and assessed the pZE1L-lexA plasmid for persistence levels with ofloxacin (5 μg/mL) with 8 hours of growth followed by 8 hours of treatment. The inventors constructed the pZE1L-lexA plasmid by utilizing the P_(L)lexO promoter described in (Dwyer et al., (2007) Mol Syst Biol 3: 91). Cells containing the pZE1L-lexA construct produced about 1.44 log₁₀ (CFU/mL) less persisters compared with wild-type E. coli EMG2 (FIG. 10). The inventors also made changes in the design of pZE1L-lexA by using non-cleavable lexA variants.

The inventors demonstrated, in lytic phage such as T7 or lysogenic phage such as M13 and using synthetic biology, construction of engineered phage by inserting the vector constructs simply into optimal regions in the phage genome to be expressed during infection (Lu et al., (2007) Proc Natl Acad Sci USA 104: 11197-11202). M13 is a filamentous, male-specific phage with a single-stranded, circular DNA genome that infects E. coli. During infection, the genome adopts a double-stranded replicative form (RF) which can be stably maintained in lysogeny. M13 subsequently replicates and secretes mature phage particles into the surrounding environment that can infect other cells. M13 is a commonly used phage for peptide display and DNA sequencing and has been modified for genetic manipulation. In some embodiments, M13 and other lysogenic phage can be used as carriers for asRNAs or other genetic modules because they allow propagation of the introduced constructs throughout a bacterial population without massive lysis, which can lead to release of toxic products such as endotoxin or lead to the development of phage resistant bacteria due to strong evolutionary pressure. As the constructs need to be able to reach a large population of cells, have the desired effects, and then be subsequently killed by antibiotic therapy, lysogenic phages were used by the inventors. For example, the gene constructs could be cloned in place of the lacZ gene in the already modified M13mp18 bacteriophage under the control of a strong bacterial-species-specific promoter or phage-specific promoter.

Herein, the inventors have demonstrated that building effective bacteriophage adjuvants that target different factors individually or in combination can be achieved in a modular fashion. As the cost of DNA sequencing and synthesis technologies continues to be reduced, large-scale modifications of phage libraries should become feasible⁶²⁻⁶⁴. With current technology, an entire engineered M13mp18 genome carrying multiple constructs to target genetic networks could be synthesized for less than $10,000, a price which is sure to decrease in the future⁶⁵. Furthermore, systems biology techniques can be employed to more rapidly identify new targets to be used in engineered bacteriophage^(43,44). Antisense RNA could also be delivered by bacteriophage to enhance killing of bacteria. Cocktails of engineered phage such as those described here could be combined with biofilm-dispersing bacteriophage and antibiotics to increase the removal of harmful biofilms³⁸.

Since the FDA recently approved the use of bacteriophage against Listeria monocytogenes in food products, it is likely that the engineered phages as disclosed herein can be readily adopted for medical, industrial, agricultural, and food processing settings where bacterial biofilms and other difficult-to-clear bacteria are present^(38,69). Potentiating bacterial killing in non-medical settings should have economic advantages in addition to reducing community-acquired antibiotic resistance¹².

Conventional drugs typically achieve their therapeutic effect by reducing protein function. In contrast, the bacteriophage and selective gene targeting approach as described herein potentiates killing by antibiotics by overexpressing proteins that affect genetic networks, such as lexA3, soxR, and csrA, or that act on their own to modulate antibiotic sensitivity, such as ompF. By reducing the SOS response with engineered M13mp18-lexA3 bacteriophage, the inventors have potentiated ofloxacin's bactericidal effect by over 4.5 orders of magnitude and reduced the number of persister cells (FIG. 1 b). The inventors have also demonstrated that other factors such as soxR, csrA, and ompF could be targeted for overexpression individually or in combination to enhance killing (FIG. 6). The inventors demonstrated that the number of mutants which acquired antibiotic resistance was significantly decreased by the use of engineered M13mp18-lexA3 bacteriophage in combination with ofloxacin (FIG. 7). In addition, the inventors confirmed that our engineered bacteriophage could be used as antibiotic adjuvants for other drugs such as aminoglycosides and β-lactams (FIG. 8). Combination therapy with antibiotics and engineered phage resulted in no noticeable development of phage resistance. The inventors demonstrated that targeting genetic networks in bacteria which are not primary antibiotic targets yield substantial improvements in killing by antimicrobial drugs. Advances in systems biology and synthetic biology should enable the practical application of engineered bacteriophage with antibiotics as a new combination therapy for combating bacterial infections.

TABLE 2A Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Ciprofloxacin antimicrobial agent. Code: ^(a)Accession Number (from world-wide web “ecocyc.org”), ^(b)Categories are as follows: 1-DNA replication, recombination and repair, 1A-functions indirectly affecting category 1,2-transport, efflux, cell wall and cell membrane synthesis, 2A-chaperones and functions related to 2, 3-protein synthesis, 4-central metabolic reactions, 5-regulation, 6-prophage encoded genes; cell adhesion, or 7-unassigned genes. ^(c)Gene knockout(s) from KEIO collection (3) using BW25113 (10) as the starting strain. Table 2A: Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Ciprofloxacin antimicrobial agent MIC (ng/mL) Locus E- Tag^(a) Gene Gene Product Category^(b) Test Plating BW25113^(c) — 16  20 b1413 hrpA ATP-dependent helicase 1 — 8.75 b2699 recA DNA strand exchange and recombination 1 2 >8.75 protein with protease and nuclease activity b2820 recB DNA helicase, ATP-dependent 1 — 7.5 dsDNA/ssDNA exonuclease b2822 recC DNA helicase, ATP-dependent 1 8 >8.75 dsDNA/ssDNA exonuclease b3652 recG ATP-dependent DNA helicase, resolution of 1 6 6 Holliday junctions, branch migrations b2616 recN Recombination and repair protein 1 — 10 b1861 ruvA Holliday junction DNA helicase 1 — 10 b1863 ruvC Holliday junction nuclease; resolution of 1 8 >8.75 structures; repair b3813 uvrD DNA-dependent ATPase I and helicase II 1 5 6 b2509 xseA Exodeoxyribonuclease VII large subunit 1 6 6 b0422 xseB Exodeoxyribonuclease VII small subunit 1 — 8 b3261 fis DNA-binding protein - chromosome   1A 6 >8.75 compaction b1712 ihfA Integration host factor alpha-subunit (IHF-   1A — 7.5 alpha). b0464 acrA AcrAB-TolC Multidrug Efflux Transport 2 — 7.5 System b0462 acrB AcrAB-TolC Multidrug Efflux Transport 2 — 8 System b3035 tolC AcrAB-TolC Multidrug Efflux Transport 2 4 5 System b0742 ybgF Predicted plasma protein 2 — 7.5 b0489 qmcA Putative protease 3 — >8.75 b0852 rimK Ribosomal protein S6 modification protein. 3 — >8.75 b1317 pgmB β-phosphoglucomutase 4 — 10 b0736 ybgC Acyl-CoA thioesterase - cytoplasm 4 — 7.5 b2767 ygcO Predicted 4Fe-4S cluster-containing protein 4 — 7.5 b1284 deoT DNA-binding transcriptional regulator 5 — 7.5 b0145 dksA RNA polymerase-binding transcription factor 5 — 10 b4172 hfq HF-I, host factor for RNA phage Q β 5 — 7.5 replication b2572 rseA Sigma-E factor negative regulatory protein. 5 — >8.75 b1280 yciM Putative heat shock protein 5 — 7.5 b1233 ychJ Conserved protein YchJ 7 — 7.5 b4402 yjjY Predicted protein YjjY 7 — 8.75

TABLE 2B Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Vancomycin antimicrobial agent, or analogue or varient thereof. Table 2B: Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Vancomycin antimicrobial agent, or analogue or varient thereof Locus MIC (μg/mL) Tag Gene Gene Product Category Plating E Test BW25113 500 — b3613 envC Cytokinesis - murein hydrolase 2 150 — b3404 envZ Osmolarity sensor protein 2 150 — b0588 fepC Ferric enterobactin transport ATP-binding 2 150 — protein b3201 lptB ATP-binding LptAB-YrbK ABC transporter 2 150   2.0 b1855 msbB Myristoyl-acyl carrier acyltransferase 2 150 — b0741 pal Peptidoglycan-associated lipoprotein 2 100 96 precursor. b2678 proW Glycine betaine/L-proline transport/permease 2 150 — b2617 smpA Outer membrane lipoprotein 2 100 70 b1252 tonB Cytoplasmic membrane protein; energy 2 125 — transducer b2512 yfgL Lipoprotein-outer membrane protein 2 150 — assembly b3245 yhdP Transporter activity, membrane protein 2 125 — b2527 hscB Hsc20 co-chaperone, with Hsc66 IscU iron-   2A 150 — sulfur cluster b0178 skp Periplasmic chaperone   2A 75 — b0053 surA Peptidyl-prolyl cis-trans isomerase PPIase   2A 8  4 and chaperone b0939 ycbR Predicted periplasmic pilin chaperone   2A 150 — b0742 ybgF Predicted periplasmic protein 2 100 — b2269 elaD Deubiquitinase 3 150 — b0852 rimK Ribosomal protein S6 modification protein. 3 150 — b3299 rpmJ 50S ribosomal protein L36 (Ribosomal 3 150 — protein B). b3179 rrmJ 23S rRNA m2U2552 methyltransferase 3 150 — b3344 tusC tRNA modification - sulfur transfer protein 3 150 — complex b3345 tusD tRNA modification - sulfur transfer protein 3 150 — complex b2494 yfgC Predicted peptidase 3 150 — b1317 pgmB Putative beta-phosphoglucomutase 4 100 — b1773 ydjI Predicted adolase 4 100 — b0145 dksA RNA polymerase-binding transcription factor 5 125 — b1237 hns DNA-binding protein H-NS 5 150 — b3961 oxyR OxyR transcriptional dual regulator 5 150 — b2405 xapR Xanthosine operon regulatory protein. 5 100 — b1280 yciM Putative heat shock protein 5 100 — b1553 ydfP Qin prophage; conserved protein 6 150 —

TABLE 2C Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Rifampicin antimicrobial agent, or analogue or varient thereof Table 2C: Example of a genes which can be inhibited by an repressor- engineered bacteriophage, and in some embodiments, such repressor- engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Rifampicin antimicrobial agent, or analogue or varient thereof MIC Locus (μg/mL) Tag Gene Gene Product Category Plating BW25113 16 b2822 recC DNA helicase, ATP-dependent 1 7.5 dsDNA/ssDNA exonuclease b2616 recN Recombination and repair protein 1 7.5 b1652 rnt Ribonuclease T 1 >10 b4058 uvrA Excision nuclease subunit A 1 7.5 b3781 trxA Thioredoxin electron transfer protein 1A 5 b0464 acrA AcrAB-TolC Multidrug Efflux Transport 2 >10 System b0462 acrB AcrAB-TolC Multidrug Efflux Transport 2 10 System b3613 envC Cytokinesis - murein hydrolase 2 10 b3404 envZ Osmolarity sensor protein 2 10 b0588 fepC Ferric enterobactin transport ATP-binding 2 10 protein b1677 lpp Major outer membrane lipoprotein precursor 2 5 b3201 lptB ATP-binding LptAB-YrbK ABC transporter 2 10 b1855 msbB Lipid A biosynthesis (KDO)2-(lauroyl)-lipid 2 7.5 IVA acyltransferase b0741 pal Peptidoglycan-associated lipoprotein 2 5 precursor. b1090 plsX Fatty acid/phospholipid synthesis protein plsX. 2 10 b0525 ppiB Peptidyl-prolyl cis-trans isomerase B 2 5 b3726 pstA Phosphate transport system permease protein 2 5 b3728 pstS Phosphate-binding periplasmic protein 2 7.5 precursor b3619 rfaD ADP-L-glycero-D-manno-heptose-6- 2 10 epimerase b3052 rfaE Heptose 1-phosphate adenyltransferase 2 7.5 b3631 rfaG Lipopolysaccharide core biosynthesis protein 2 2 b2617 smpA Outer membrane lipoprotein 2 5 b3838 tatB Sec-independent protein translocase TatB 2 10 b3839 tatC Sec-independent protein translocase TatC 2 10 b0738 tolR Colicin import; Tolerance to group A colicins 2 3.5 b1252 tonB Cytoplasmic membrane protein; energy 2 >10 transducer b0742 ybgF Predicted periplasmic protein 2 >10 b2512 yfgL Lipoprotein-outer membrane protein assembly 2 >10 b2807 ygdD Conserved inner membrane protein 2 10 b3245 yhdP Transporter activity, membrane protein 2 10 b0161 degP Periplasmic serine protease and chaperone 2A 10 b0014 dnaK Chaperone protein - chaperone Hsp70; DNA 2A 7.5 biosynthesis b0178 skp Periplasmic chaperone 2A 5 b0053 surA Peptidyl-prolyl cis-trans isomerase PPIase and 2A 2 chaperone b0939 ycbR Predicted periplasmic pilin chaperone 2A 10 b2269 elaD Deubiquitinase 3 >10 b4375 prfC Peptide chain release factor 3 (RF-3). 3 10 b0489 qmcA Putative protease 3 10 b0852 rimK Ribosomal protein S6 modification protein. 3 10 b1269 rluB 23s rRNA pseudouridine synthase 3 10 b3984 rplA 50S ribosomal protein L1. 3 7.5 b3936 rpmE 50S ribosomal protein L31. 3 5 b1089 rpmF 50S ribosomal protein L32. 3 7.5 b3299 rpmJ 50S ribosomal protein L36 (Ribosomal protein 3 7.5 B). b2494 yfgC Predicted peptidase 3 5 b1095 fabF β-ketoacyl-ACP synthase 4 5 b3058 folB Dihydroneopterin aldolase 4 >10 b4395 gpmB Probable phosphoglycerate mutase gpmB 4 10 B3612 gpmM phosphoglycerate mutase, cofactor 4 >10 independent b0677 nagA N-acetylglucosamine-6-phosphate deacetylase 4 5 b1317 pgmB β-phosphoglucomutase 4 10 b3386 rpe Ribulose-phosphate 3-epimerase 4 10 b1731 cedA Cell division activator 5 10 b4172 hfq HF-I, host factor for RNA phage Q β 5 10 replication b1237 hns DNA-binding protein H-NS 5 7.5 b3842 rfaH Transcriptional activator rfaH. 5 7.5 b2572 rseA Sigma-E factor negative regulatory protein. 5 7.5 b2405 xapR Xanthosine operon regulatory protein. 5 >10 b1280 yciM Putative heat shock protein 5 7.5 b0547 ybcN Hypothetical protein in lambdoid DLP12 6 7.5 prophage region b0550.1 ylcG DLP12 prophage; predicted protein 6 5 b0659 ybeY Hypothetical protein 7 10 b1088 yceD Hypothetical protein 7 5 b1233 ychJ Hypothetical protein 7 7.5 b4402 yjjY Hypothetical protein yjjY. 7 >10

TABLE 2D Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with an Ampicillin antimicrobial agent, or analogue or varient thereof Table 2D: Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with an Ampicillin antimicrobial agent, or analogue or varient thereof Locus MIC (μg/mL) Tag Gene Gene Description Category E test Plating BW25113 5.0 6.0 b3017 sufI Suppressor of essential cell division protein FtsI 1A, 2 — 2.0 b0464 acrA AcrAB-TolC Multidrug Efflux Transport System 2 — 1.5 b0462 acrB AcrAB-TolC Multidrug Efflux Transport System 2 — 2.0 b3035 tolC AcrAB-TolC Multidrug Efflux Transport System 2 1.0 2.0 b0632 dacA Penicillin-binding protein 5 precursor 2 1.5 1.5 b0092 ddlB Subunit of D-alanine:D-alanine ligase B, ADP- 2 — 1.0 forming b2314 dedD Putative lipoprotein - inner membrane 2 — 2.0 b1193 emtA :ytic murein transglycosylase E 2 — 2.0 b3613 envC Cytokinesis - murein hydrolase 2 — 1.5 b3201 lptB ATP-binding LptAB-YrbK ABC transporter 2 — 2.0 b0149 mrcB Subunit of 5-methylcytosine restriction system 2 — 2.0 b0741 pal Peptidoglycan-associated lipoprotein precursor. 2 2.0 1.5 b3838 tatB Sec-independent protein translocase TatB 2 1.5 1.5 b3839 tatC Sec-independent protein translocase TatC 2 3.0 2.0 b0738 tolR Colicin import; Tol-pal system component 2 — 2.0 b0742 ybgF Hypothetical protein ybgF precursor. 2 — 1.5 b0028 fkpB FKBP-type 16 kDa peptidyl-prolyl cis-trans 2A — 2.5 isomerase b2526 hscA Chaperone, member of Hsp70 protein family 2A — 2.0 b2527 hscB Hsc20 co-chaperone that acts with Hsc66 in IscU 2A — 2.5 iron-sulfur cluster b0178 skp Periplasmic chaperone 2A — 2.0 b0053 surA Peptidyl-prolyl cis-trans isomerase PPIase and 2A — 2.0 chaperone b0489 qmcA Putative protease 3 — 2.5 b0852 rimK Ribosomal protein S6 modification protein. 3 — 2.0 b3984 rplA 50S ribosomal protein L1. 3 2.0 2.0 b1089 rpmF 50S ribosomal protein L32. 3 — 1.5 b4200 rpsF 30S ribosomal protein S6. 3 — 2.0 b3179 rrmJ 23S rRNA m2U2552 methyltransferase 3 — 1.5 b2494 yfgC Hypothetical protein yfgC precursor. 3 — 1.5 b2512 yfgL Lipoprotein component of outer membrane 3 — 2.0 protein assembly complex b3734 atpA ATP synthase alpha chain 4 — 2.5 b3809 dapF Diaminopimelate epimerase 4 2.0 1.0 b2065 dcd Deoxycytidine triphosphate deaminase (dTP) 4 — 2.5 b3612 gpmM Phosphoglycerate mutase, cofactor independent 4 — 1.5 b1317 pgmB β-phosphoglucomutase 4 — 1.5 b2232 ubiG 3-demethylubiquinone-9 3-methyltransferase 4 — 2.0 b2767 ygcO Predicted 4Fe-4S cluster-containing protein 4 — 2.0 b1284 deoT DNA-binding transcriptional regulator 5 — 2.0 b0145 dksA RNA polymerase-binding transcription factor 5 — 2.0 b1130 phoP Transcriptional regulatory protein 5 — 2.0 b2405 xapR Xanthosine operon regulatory protein. 5 — 1.5 b1280 yciM Putative heat shock proteins 5 — 1.5 JW5115 Hypothetical protein 7 — 2.0 b0631 ybeD conserved protein YbeD 7 — 2.0 b0659 ybeY conserved protein Ybey 7 — 2.0 b0762 ybhT Hypothetical protein YbhT precursor 7 — 2.0 b4402 yjjY predicted protein YjjY 7 — 1.5

TABLE 2E Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Sulfamethaxazone antimicrobial agent, or analogue or varient thereof. Table 2E: Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a Sulfamethaxazone antimicrobial agent, or analogue or varient thereof MIC Locus (μg/mL) Tag Gene Gene Product Category Plating BW25113 1000 b1865 nudB dATP pyrophosphohydrolase 1 350 b2699 recA DNA strand exchange and recombination protein 1 400 b2820 recB DNA helicase, ATP-dependent dsDNA/ssDNA 1 350 exonuclease b2822 recC DNA helicase, ATP-dependent dsDNA/ssDNA 1 350 exonuclease b3652 recG ATP-dependent DNA helicase, resolution of 1 500 Holliday junctions b3261 fis DNA-binding protein - chromosome compaction 1A 600 b3613 envC Cytokinesis - murein hydrolase 2 400 b3201 lptB ATP-binding LptAB-YrbK ABC transporter 2 500 b3726 pstA Phosphate transport system permease 2 550 b3728 pstS Phosphate-binding periplasmic protein 2 550 b3052 rfaE Heptose 1-phosphate adenyltransferase 2 550 b3035 tolC AcrAB-TolC Multidrug Efflux Transport System 2 400 b0742 ybgF Predicted plasma protein 2 >550 b1279 yciS Conserved inner membrane protein 2 550 b2512 yfgL Lipoprotein component of outer membrane protein 2 400 assembly complex b1520 yneE Conserved inner membrane protein 2 550 b0161 degP Periplasmic serine protease and chaperone 2A 500 b0014 dnaK Chaperone protein - chaperone Hsp70; DNA 2A 300 biosynthesis b0489 qmcA Putative protease 3 550 b0852 rimK Ribosomal protein S6 modification protein. 3 350 b3984 rplA 50S ribosomal protein L1. 3 500 b1089 rpmF 50S ribosomal protein L32. 3 550 b3065 rpsU 30S ribosomal protein S21. 3 500 b3809 dapF Diaminopimelate epimerase 4 300 b2065 dcd Deoxycytidine triphosphate deaminase (dTP) 4 >550 b3612 gpmM Phosphoglycerate mutase, cofactor independent 4 400 b0116 lpdA Dihydrolipoamide dehydrogenase (Glycine 4 400 cleavage) b1317 pgmB β-phosphoglucomutase 4 500 b1773 ydjI Predicted adolase 4 >550 b2767 ygcO Predicted 4Fe-4S cluster-containing protein 4 550 b1284 deoT DNA-binding transcriptional regulator 5 550 b0145 dksA Transcription initiation factor 5 550 b1237 hns DNA-binding protein H-NS 5 550 b2572 resA Sigma-E factor negative regulatory protein. 5 >550 b2405 xapR Xanthosine operon regulatory protein. 5 >550 b1280 yciM Putative heat shock protein 5 >550 b0550.1 ylcG DLP12 prophage; predicted protein 6 500 b1143 ymfI Prophage genes - e14 prophage; predicted protein 6 500 JW5115 Hypothetical protein 7 400 JW5474 Hypothetical protein 7 500 b0659 ybeY Hypothetical protein 7 500 b3928 yiiU Conserved protein YiiU 7 550 b4402 yjjY Predicted protein YjjY 7 >550

TABLE 2F Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a gentamicin antimicrobial agent, or analogue or varient thereof Table 2F: Example of a genes which can be inhibited by an repressor-engineered bacteriophage, and in some embodiments, such repressor-engineered bacteriophages which inhibit one or more of the following non-SOS defense genes are useful in combination with a gentamicin antimicrobial agent, or analogue or varient thereof MIC Locus (μg/mL) Tag Gene Gene Product Category Plating BW25113 0.8 b1652 rnt Ribonuclease T 1 0.7 b3613 envC Cytokinesis - murein hydrolase 2 >0.5 b3621 rfaC Lipopolysaccharide heptosyltransferase-1 2 0.7 b3791 rffA dTDP-4-oxo-6-deoxy-D-glucose transaminase 2 0.7 b1292 sapC Peptide transport system permease protein 2 0.5 b3175 secG Protein-export membrane - Sec Protein Secretion 2 0.5 Complex b3839 tatC Sec-independent protein translocase TatC 2 0.5 b3035 tolC AcrAB-TolC Multidrug Efflux Transport System 2 0.5 b4174 hflK Regulator of FtsH protease 3 0.5 b4203 rplI 50S ribosomal protein L9. 3 0.7 b3936 rpmE 50S ribosomal protein L31. 3 0.6 b3344 tusC tRNA modification - sulfur transfer protein 3 0.5 complex b3345 tusD tRNA modification - sulfur transfer protein 3 0.5 complex b2494 yfgC Predicted peptidase 3 >0.5 b3809 dapF Diaminopimelate epimerase 4 0.7 b3612 gpmM Phosphoglycerate mutase, cofactor independent 4 0.7 b3202 rpoN RNA polymerase sigma-54 factor. 5 0.5 b2405 xapR Xanthosine operon regulatory protein. 5 >0.5 b1280 yciM Putative heat shock protein 5 >0.7 JW5360 Hypothetical protein 7 >0.8 b4557 yidD Predicted protein YidD 7 0.5

TABLE 5 Examples of bacteriophages which can be engineered to be an inhibitor-engineered bacteriophage, or a repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage as disclosed herein. Table 5: Examples of bacteriophages which can be engineered to be an inhibitor-engineered bacteriophage, or a repressor-engineered bacteriophage or a susceptibility-engineered bacteriophage as disclosed herein. organism accession length proteins RNAs genes Acholeplasma phage L2 NC_001447 11965 nt 14 0 14 Acholeplasma phage MV-L1 NC_001341 4491 nt 4 0 4 Acidianus bottle-shaped virus NC_009452 23814 nt 57 0 57 Acidianus filamentous virus 1 NC_005830 20869 nt 40 0 40 Acidianus filamentous virus 2 NC_009884 31787 nt 52 1 53 Acidianus filamentous virus 3 NC_010155 40449 nt 68 0 68 Acidianus filamentous virus 6 NC_010152 39577 nt 66 0 66 Acidianus filamentous virus 7 NC_010153 36895 nt 57 0 57 Acidianus filamentous virus 8 NC_010154 38179 nt 61 0 61 Acidianus filamentous virus 9 NC_010537 41172 nt 73 0 73 Acidianus rod-shaped virus 1 NC_009965 24655 nt 41 0 41 Acidianus two-tailed virus NC_007409 62730 nt 72 0 72 Acinetobacter phage AP205 NC_002700 4268 nt 4 0 4 Actinomyces phage Av-1 NC_009643 17171 nt 22 1 23 Actinoplanes phage phiAsp2 NC_005885 58638 nt 76 0 76 Acyrthosiphon pisum secondary NC_000935 36524 nt 54 0 54 endosymbiont phage 1 Aeromonas phage 25 NC_008208 161475 nt 242 13 242 Aeromonas phage 31 NC_007022 172963 nt 247 15 262 Aeromonas phage 44RR2.8t NC_005135 173591 nt 252 17 269 Aeromonas phage Aeh1 NC_005260 233234 nt 352 23 375 Aeromonas phage phiO18P NC_009542 33985 nt 45 0 45 Archaeal BJ1 virus NC_008695 42271 nt 70 1 71 Azospirillum phage Cd NC_010355 62337 nt 95 0 95 Bacillus phage 0305phi8-36 NC_009760 218948 nt 246 0 246 Bacillus phage AP50 NC_011523 14398 nt 31 0 31 Bacillus phage B103 NC_004165 18630 nt 17 0 17 Bacillus phage BCJA1c NC_006557 41092 nt 58 0 58 Bacillus phage Bam35c NC_005258 14935 nt 32 0 32 Bacillus phage Cherry NC_007457 36615 nt 51 0 51 Bacillus phage Fah NC_007814 37974 nt 50 0 50 Bacillus phage GA-1 NC_002649 21129 nt 35 1 52 Bacillus phage GIL16c NC_006945 14844 nt 31 0 31 Bacillus phage Gamma NC_007458 37253 nt 53 0 53 Bacillus phage IEBH NC_011167 53104 nt 86 0 86 Bacillus phage SPBc2 NC_001884 134416 nt 185 0 185 Bacillus phage SPO1 NC_011421 132562 nt 204 5 209 Bacillus phage SPP1 NC_004166 44010 nt 101 0 101 Bacillus phage TP21-L NC_011645 37456 nt 56 0 56 Bacillus phage WBeta NC_007734 40867 nt 53 0 53 Bacillus phage phBC6A51 NC_004820 61395 nt 75 0 75 Bacillus phage phBC6A52 NC_004821 38472 nt 49 0 49 Bacillus phage phi105 NC_004167 39325 nt 51 0 51 Bacillus phage phi29 NC_011048 19282 nt 27 0 27 Bacillus virus 1 NC_009737 35055 nt 54 0 54 Bacteriophage APSE-2 NC_011551 39867 nt 41 1 42 Bacteroides phage B40-8 NC_011222 44929 nt 46 0 46 Bdellovibrio phage phiMH2K NC_002643 4594 nt 11 0 11 Bordetella phage BIP-1 NC_005809 42638 nt 48 0 48 Bordetella phage BMP-1 NC_005808 42663 nt 47 0 47 Bordetella phage BPP-1 NC_005357 42493 nt 49 0 49 Burkholderia ambifaria phage BcepF1 NC_009015 72415 nt 127 0 127 Burkholderia phage Bcep1 NC_005263 48177 nt 71 0 71 Burkholderia phage Bcep176 NC_007497 44856 nt 81 0 81 Burkholderia phage Bcep22 NC_005262 63879 nt 81 1 82 Burkholderia phage Bcep43 NC_005342 48024 nt 65 0 65 Burkholderia phage Bcep781 NC_004333 48247 nt 66 0 66 Burkholderia phage BcepB1A NC_005886 47399 nt 73 0 73 Burkholderia phage BcepC6B NC_005887 42415 nt 46 0 46 Burkholderia phage BcepGomr NC_009447 52414 nt 75 0 75 Burkholderia phage BcepMu NC_005882 36748 nt 53 0 53 Burkholderia phage BcepNY3 NC_009604 47382 nt 70 1 70 Burkholderia phage BcepNazgul NC_005091 57455 nt 73 0 73 Burkholderia phage KS10 NC_011216 37635 nt 49 0 49 Burkholderia phage phi1026b NC_005284 54865 nt 83 0 83 Burkholderia phage phi52237 NC_007145 37639 nt 47 0 47 Burkholderia phage phi644-2 NC_009235 48674 nt 71 0 71 Burkholderia phage phiE12-2 NC_009236 36690 nt 50 0 50 Burkholderia phage phiE125 NC_003309 53373 nt 71 0 71 Burkholderia phage phiE202 NC_009234 35741 nt 48 0 48 Burkholderia phage phiE255 NC_009237 37446 nt 55 0 55 Chlamydia phage 3 NC_008355 4554 nt 8 0 8 Chlamydia phage 4 NC_007461 4530 nt 8 0 8 Chlamydia phage CPAR39 NC_002180 4532 nt 7 0 7 Chlamydia phage Chp1 NC_001741 4877 nt 12 0 12 Chlamydia phage Chp2 NC_002194 4563 nt 8 0 7 Chlamydia phage phiCPG1 NC_001998 4529 nt 9 0 9 Clostridium phage 39-O NC_011318 38753 nt 62 0 62 Clostridium phage c-st NC_007581 185683 nt 198 0 198 Clostridium phage phi CD119 NC_007917 53325 nt 79 0 79 Clostridium phage phi3626 NC_003524 33507 nt 50 0 50 Clostridium phage phiC2 NC_009231 56538 nt 82 0 82 Clostridium phage phiCD27 NC_011398 50930 nt 75 0 75 Clostridium phage phiSM101 NC_008265 38092 nt 53 1 54 Corynebacterium phage BFK20 NC_009799 42969 nt 54 0 54 Corynebacterium phage P1201 NC_009816 70579 nt 97 4 101 Enterobacteria phage 13a NC_011045 38841 nt 55 0 55 Enterobacteria phage 933W NC_000924 61670 nt 80 4 84 Enterobacteria phage BA14 NC_011040 39816 nt 52 0 52 Enterobacteria phage BP-4795 NC_004813 57930 nt 85 0 85 Enterobacteria phage BZ13 NC_001426 3466 nt 4 0 4 Enterobacteria phage EPS7 NC_010583 111382 nt 170 0 171 Enterobacteria phage ES18 NC_006949 46900 nt 79 0 79 Enterobacteria phage EcoDS1 NC_011042 39252 nt 53 0 53 Enterobacteria phage FI sensu lato NC_004301 4276 nt 4 0 4 Enterobacteria phage Felix 01 NC_005282 86155 nt 131 22 153 Enterobacteria phage Fels-2 NC_010463 33693 nt 47 0 48 Enterobacteria phage G4 sensu lato NC_001420 5577 nt 11 0 13 Enterobacteria phage HK022 NC_002166 40751 nt 57 0 57 Enterobacteria phage HK620 NC_002730 38297 nt 58 0 58 Enterobacteria phage HK97 NC_002167 39732 nt 61 0 62 Enterobacteria phage I2-2 NC_001332 6744 nt 9 0 9 Enterobacteria phage ID18 sensu lato NC_007856 5486 nt 11 0 11 Enterobacteria phage ID2 NC_007817 5486 nt 11 0 11 Moscow/ID/2001 Enterobacteria phage If1 NC_001954 8454 nt 10 0 10 Enterobacteria phage Ike NC_002014 6883 nt 10 0 10 Enterobacteria phage JK06 NC_007291 46072 nt 82 0 82 Enterobacteria phage JS98 NC_010105 170523 nt 266 3 269 Enterobacteria phage K1-5 NC_008152 44385 nt 52 0 52 Enterobacteria phage K1E NC_007637 45251 nt 62 0 62 Enterobacteria phage K1F NC_007456 39704 nt 43 0 41 Enterobacteria phage M13 NC_003287 6407 nt 10 0 10 Enterobacteria phage MS2 NC_001417 3569 nt 4 0 4 Enterobacteria phage Min27 NC_010237 63395 nt 83 3 86 Enterobacteria phage Mu NC_000929 36717 nt 55 0 55 Enterobacteria phage N15 NC_001901 46375 nt 60 0 60 Enterobacteria phage N4 NC_008720 70153 nt 72 0 72 Enterobacteria phage P1 NC_005856 94800 nt 110 4 117 Enterobacteria phage P2 NC_001895 33593 nt 43 0 43 Enterobacteria phage P22 NC_002371 41724 nt 72 2 74 Enterobacteria phage P4 NC_001609 11624 nt 14 5 19 Enterobacteria phage PRD1 NC_001421 14927 nt 31 0 31 Enterobacteria phage Phi1 NC_009821 164270 nt 276 0 276 Enterobacteria phage PsP3 NC_005340 30636 nt 42 0 42 Enterobacteria phage Qbeta NC_001890 4215 nt 4 0 4 Enterobacteria phage RB32 NC_008515 165890 nt 270 8 270 Enterobacteria phage RB43 NC_007023 180500 nt 292 1 292 Enterobacteria phage RB49 NC_005066 164018 nt 279 0 279 Enterobacteria phage RB69 NC_004928 167560 nt 273 2 275 Enterobacteria phage RTP NC_007603 46219 nt 75 0 75 Enterobacteria phage SP6 NC_004831 43769 nt 52 0 52 Enterobacteria phage ST104 NC_005841 41391 nt 63 0 63 Enterobacteria phage ST64T NC_004348 40679 nt 65 0 65 Enterobacteria phage Sf6 NC_005344 39043 nt 66 2 70 Enterobacteria phage SfV NC_003444 37074 nt 53 0 53 Enterobacteria phage T1 NC_005833 48836 nt 78 0 78 Enterobacteria phage T3 NC_003298 38208 nt 55 0 56 Enterobacteria phage T4 NC_000866 168903 nt 278 10 288 Enterobacteria phage T5 NC_005859 121750 nt 162 33 195 Enterobacteria phage T7 NC_001604 39937 nt 60 0 60 Enterobacteria phage TLS NC_009540 49902 nt 87 0 87 Enterobacteria phage VT2-Sakai NC_000902 60942 nt 83 3 86 Enterobacteria phage WA13 sensu lato NC_007821 6068 nt 10 0 10 Enterobacteria phage YYZ-2008 NC_011356 54896 nt 75 0 75 Enterobacteria phage alpha3 NC_001330 6087 nt 10 0 10 Enterobacteria phage epsilon15 NC_004775 39671 nt 51 0 51 Enterobacteria phage lambda NC_001416 48502 nt 73 0 92 Enterobacteria phage phiEco32 NC_010324 77554 nt 128 1 128 Enterobacteria phage phiEcoM-GJ1 NC_010106 52975 nt 75 1 76 Enterobacteria phage phiP27 NC_003356 42575 nt 58 2 60 Enterobacteria phage phiV10 NC_007804 39104 nt 55 0 55 Enterobacteria phage phiX174 sensu NC_001422 5386 nt 11 0 11 lato Enterococcus phage phiEF24C NC_009904 142072 nt 221 5 226 Erwinia phage Era103 NC_009014 45445 nt 53 0 53 Erwinia phage phiEa21-4 NC_011811 84576 nt 118 26 144 Escherichia phage rv5 NC_011041 137947 nt 233 6 239 Flavobacterium phage 11b NC_006356 36012 nt 65 0 65 Geobacillus phage GBSV1 NC_008376 34683 nt 54 0 54 Geobacillus virus E2 NC_009552 40863 nt 71 0 71 Haemophilus phage Aaphi23 NC_004827 43033 nt 66 0 66 Haemophilus phage HP1 NC_001697 32355 nt 42 0 42 Haemophilus phage HP2 NC_003315 31508 nt 37 0 37 Haloarcula phage SH1 NC_007217 30889 nt 56 0 56 Halomonas phage phiHAP-1 NC_010342 39245 nt 46 0 46 Halorubrum phage HF2 NC_003345 77670 nt 114 5 119 Halovirus HF1 NC_004927 75898 nt 102 4 106 His1 virus NC_007914 14462 nt 35 0 35 His2 virus NC_007918 16067 nt 35 0 35 Iodobacteriophage phiPLPE NC_011142 47453 nt 84 0 84 Klebsiella phage K11 NC_011043 41181 nt 51 0 51 Klebsiella phage phiKO2 NC_005857 51601 nt 64 0 63 Kluyvera phage Kvp1 NC_011534 39472 nt 47 1 48 Lactobacillus johnsonii prophage NC_010179 40881 nt 56 0 56 Lj771 Lactobacillus phage A2 NC_004112 43411 nt 61 0 64 Lactobacillus phage KC5a NC_007924 38239 nt 61 0 61 Lactobacillus phage LL-H NC_009554 34659 nt 51 0 51 Lactobacillus phage LP65 NC_006565 131522 nt 165 14 179 Lactobacillus phage Lc-Nu NC_007501 36466 nt 51 0 51 Lactobacillus phage Lrm1 NC_011104 39989 nt 54 0 54 Lactobacillus phage Lv-1 NC_011801 38934 nt 47 0 47 Lactobacillus phage phiAT3 NC_005893 39166 nt 55 0 55 Lactobacillus phage phiJL-1 NC_006936 36674 nt 46 0 46 Lactobacillus phage phiadh NC_000896 43785 nt 63 0 63 Lactobacillus phage phig1e NC_004305 42259 nt 50 0 62 Lactobacillus prophage Lj928 NC_005354 38384 nt 50 1 50 Lactobacillus prophage Lj965 NC_005355 40190 nt 46 4 46 Lactococcus phage 1706 NC_010576 55597 nt 76 0 76 Lactococcus phage 712 NC_008370 30510 nt 55 0 55 Lactococcus phage BK5-T NC_002796 40003 nt 63 0 63 Lactococcus phage KSY1 NC_009817 79232 nt 130 3 131 Lactococcus phage P008 NC_008363 28538 nt 58 0 58 Lactococcus phage P335 sensu lato NC_004746 36596 nt 49 0 49 Lactococcus phage Q54 NC_008364 26537 nt 47 0 47 Lactococcus phage TP901-1 NC_002747 37667 nt 56 0 56 Lactococcus phage Tuc2009 NC_002703 38347 nt 56 0 56 Lactococcus phage asccphi28 NC_010363 18762 nt 28 0 27 Lactococcus phage bIBB29 NC_011046 29305 nt 54 0 54 Lactococcus phage bIL170 NC_001909 31754 nt 64 0 64 Lactococcus phage bIL285 NC_002666 35538 nt 62 0 62 Lactococcus phage bIL286 NC_002667 41834 nt 61 0 61 Lactococcus phage bIL309 NC_002668 36949 nt 56 0 56 Lactococcus phage bIL310 NC_002669 14957 nt 29 0 29 Lactococcus phage bIL311 NC_002670 14510 nt 22 0 22 Lactococcus phage bIL312 NC_002671 15179 nt 27 0 27 Lactococcus phage bIL67 NC_001629 22195 nt 37 0 0 Lactococcus phage c2 NC_001706 22172 nt 39 2 41 Lactococcus phage jj50 NC_008371 27453 nt 49 0 49 Lactococcus phage phiLC3 NC_005822 32172 nt 51 0 51 Lactococcus phage r1t NC_004302 33350 nt 50 0 50 Lactococcus phage sk1 NC_001835 28451 nt 56 0 56 Lactococcus phage ul36 NC_004066 36798 nt 61 0 61 Leuconostoc phage L5 NC_009534 2435 nt 0 0 0 Listeria phage 2389 NC_003291 37618 nt 59 1 58 Listeria phage A006 NC_009815 38124 nt 62 0 62 Listeria phage A118 NC_003216 40834 nt 72 0 72 Listeria phage A500 NC_009810 38867 nt 63 0 63 Listeria phage A511 NC_009811 137619 nt 199 16 215 Listeria phage B025 NC_009812 42653 nt 65 0 65 Listeria phage B054 NC_009813 48172 nt 80 0 80 Listeria phage P35 NC_009814 35822 nt 56 0 56 Listeria phage P40 NC_011308 35638 nt 62 0 62 Listonella phage phiHSIC NC_006953 37966 nt 47 0 47 Mannheimia phage phiMHaA1 NC_008201 34525 nt 49 0 50 Methanobacterium phage psiM2 NC_001902 26111 nt 32 0 32 Methanothermobacter phage psiM100 NC_002628 28798 nt 35 0 35 Microbacterium phage Min1 NC_009603 46365 nt 77 0 77 Microcystis phage Ma-LMM01 NC_008562 162109 nt 184 2 186 Morganella phage MmP1 NC_011085 38233 nt 47 0 47 Mycobacterium phage 244 NC_008194 74483 nt 142 2 144 Mycobacterium phage Adjutor NC_010763 64511 nt 86 0 86 Mycobacterium phage BPs NC_010762 41901 nt 63 0 63 Mycobacterium phage Barnyard NC_004689 70797 nt 109 0 109 Mycobacterium phage Bethlehem NC_009878 52250 nt 87 0 87 Mycobacterium phage Boomer NC_011054 58037 nt 105 0 105 Mycobacterium phage Brujita NC_011291 47057 nt 74 0 74 Mycobacterium phage Butterscotch NC_011286 64562 nt 86 0 86 Mycobacterium phage Bxb1 NC_002656 50550 nt 86 0 86 Mycobacterium phage Bxz1 NC_004687 156102 nt 225 28 253 Mycobacterium phage Bxz2 NC_004682 50913 nt 86 3 89 Mycobacterium phage Cali NC_011271 155372 nt 222 35 257 Mycobacterium phage Catera NC_008207 153766 nt 218 34 253 Mycobacterium phage Chah NC_011284 68450 nt 104 0 104 Mycobacterium phage Che12 NC_008203 52047 nt 98 3 101 Mycobacterium phage Che8 NC_004680 59471 nt 112 0 112 Mycobacterium phage Che9c NC_004683 57050 nt 84 1 85 Mycobacterium phage Che9d NC_004686 56276 nt 111 0 111 Mycobacterium phage Cjw1 NC_004681 75931 nt 141 1 142 Mycobacterium phage Cooper NC_008195 70654 nt 99 0 99 Mycobacterium phage Corndog NC_004685 69777 nt 122 0 122 Mycobacterium phage D29 NC_001900 49136 nt 79 5 84 Mycobacterium phage DD5 NC_011022 51621 nt 87 0 87 Mycobacterium phage Fruitloop NC_011288 58471 nt 102 0 102 Mycobacterium phage Giles NC_009993 54512 nt 79 1 80 Mycobacterium phage Gumball NC_011290 64807 nt 88 0 88 Mycobacterium phage Halo NC_008202 42289 nt 65 0 65 Mycobacterium phage Jasper NC_011020 50968 nt 94 0 94 Mycobacterium phage KBG NC_011019 53572 nt 89 0 89 Mycobacterium phage Konstantine NC_011292 68952 nt 95 0 95 Mycobacterium phage Kostya NC_011056 75811 nt 143 2 145 Mycobacterium phage L5 NC_001335 52297 nt 85 3 88 Mycobacterium phage Llij NC_008196 56852 nt 100 0 100 Mycobacterium phage Lockley NC_011021 51478 nt 90 0 90 Mycobacterium phage Myrna NC_011273 164602 nt 229 41 270 Mycobacterium phage Nigel NC_011044 69904 nt 94 1 95 Mycobacterium phage Omega NC_004688 110865 nt 237 2 239 Mycobacterium phage Orion NC_008197 68427 nt 100 0 100 Mycobacterium phage PBI1 NC_008198 64494 nt 81 0 81 Mycobacterium phage PG1 NC_005259 68999 nt 100 0 100 Mycobacterium phage PLot NC_008200 64787 nt 89 0 89 Mycobacterium phage PMC NC_008205 56692 nt 104 0 104 Mycobacterium phage Pacc40 NC_011287 58554 nt 101 0 101 Mycobacterium phage Phaedrus NC_011057 68090 nt 98 0 98 Mycobacterium phage Pipefish NC_008199 69059 nt 102 0 102 Mycobacterium phage Porky NC_011055 76312 nt 147 2 149 Mycobacterium phage Predator NC_011039 70110 nt 92 0 92 Mycobacterium phage Pukovnik NC_011023 52892 nt 88 1 89 Mycobacterium phage Qyrzula NC_008204 67188 nt 81 0 81 Mycobacterium phage Ramsey NC_011289 58578 nt 108 0 108 Mycobacterium phage Rizal NC_011272 153894 nt 220 35 255 Mycobacterium phage Rosebush NC_004684 67480 nt 90 0 90 Mycobacterium phage ScottMcG NC_011269 154017 nt 221 36 257 Mycobacterium phage Solon NC_011267 49487 nt 86 0 86 Mycobacterium phage Spud NC_011270 154906 nt 222 35 257 Mycobacterium phage TM4 NC_003387 52797 nt 89 0 89 Mycobacterium phage Troll4 NC_011285 64618 nt 84 0 84 Mycobacterium phage Tweety NC_009820 58692 nt 109 0 109 Mycobacterium phage U2 NC_009877 51277 nt 81 0 81 Mycobacterium phage Wildcat NC_008206 78441 nt 148 23 171 Mycoplasma phage MAV1 NC_001942 15644 nt 15 0 15 Mycoplasma phage P1 NC_002515 11660 nt 11 0 11 Mycoplasma phage phiMFV1 NC_005964 15141 nt 15 0 17 Myxococcus phage Mx8 NC_003085 49534 nt 86 0 85 Natrialba phage PhiCh1 NC_004084 58498 nt 98 0 98 Pasteurella phage F108 NC_008193 30505 nt 44 0 44 Phage Gifsy-1 NC_010392 48491 nt 58 1 59 Phage Gifsy-2 NC_010393 45840 nt 55 0 56 Phage cdtI NC_009514 47021 nt 60 0 60 Phage phiJL001 NC_006938 63649 nt 90 0 90 Phormidium phage Pf-WMP3 NC_009551 43249 nt 41 0 41 Phormidium phage Pf-WMP4 NC_008367 40938 nt 45 0 45 Prochlorococcus phage P-SSM2 NC_006883 252401 nt 329 1 330 Prochlorococcus phage P-SSM4 NC_006884 178249 nt 198 0 198 Prochlorococcus phage P-SSP7 NC_006882 44970 nt 53 0 53 Propionibacterium phage B5 NC_003460 5804 nt 10 0 10 Propionibacterium phage PA6 NC_009541 29739 nt 48 0 48 Pseudoalteromonas phage PM2 NC_000867 10079 nt 22 0 22 Pseudomonas phage 119X NC_007807 43365 nt 53 0 53 Pseudomonas phage 14-1 NC_011703 66235 nt 90 0 90 Pseudomonas phage 201phi2-1 NC_010821 316674 nt 461 1 462 Pseudomonas phage 73 NC_007806 42999 nt 52 0 52 Pseudomonas phage B3 NC_006548 38439 nt 59 0 59 Pseudomonas phage D3 NC_002484 56425 nt 95 4 99 Pseudomonas phage D3112 NC_005178 37611 nt 55 0 55 Pseudomonas phage DMS3 NC_008717 36415 nt 52 0 52 Pseudomonas phage EL NC_007623 211215 nt 201 0 201 Pseudomonas phage F10 NC_007805 39199 nt 63 0 63 Pseudomonas phage F116 NC_006552 65195 nt 70 0 70 Pseudomonas phage F8 NC_007810 66015 nt 91 0 91 Pseudomonas phage LBL3 NC_011165 64427 nt 87 0 87 Pseudomonas phage LKA1 NC_009936 41593 nt 56 0 56 Pseudomonas phage LKD16 NC_009935 43200 nt 53 0 53 Pseudomonas phage LMA2 NC_011166 66530 nt 93 0 93 Pseudomonas phage LUZ19 NC_010326 43548 nt 54 0 54 Pseudomonas phage LUZ24 NC_010325 45625 nt 68 0 68 Pseudomonas phage M6 NC_007809 59446 nt 85 0 85 Pseudomonas phage MP22 NC_009818 36409 nt 51 0 51 Pseudomonas phage MP29 NC_011613 36632 nt 51 0 51 Pseudomonas phage MP38 NC_011611 36885 nt 51 0 51 Pseudomonas phage PA11 NC_007808 49639 nt 70 0 70 Pseudomonas phage PAJU2 NC_011373 46872 nt 79 0 79 Pseudomonas phage PB1 NC_011810 65764 nt 93 0 94 Pseudomonas phage PP7 NC_001628 3588 nt 4 0 4 Pseudomonas phage PRR1 NC_008294 3573 nt 4 0 4 Pseudomonas phage PT2 NC_011107 42961 nt 54 0 54 Pseudomonas phage PT5 NC_011105 42954 nt 52 0 52 Pseudomonas phage PaP2 NC_005884 43783 nt 58 0 58 Pseudomonas phage PaP3 NC_004466 45503 nt 71 4 75 Pseudomonas phage Pf1 NC_001331 7349 nt 14 0 14 Pseudomonas phage Pf3 NC_001418 5833 nt 9 0 9 Pseudomonas phage SN NC_011756 66390 nt 92 0 92 Pseudomonas phage YuA NC_010116 58663 nt 77 0 77 Pseudomonas phage gh-1 NC_004665 37359 nt 42 0 42 Pseudomonas phage phi12 NC_004173 6751 nt 6 0 6 Pseudomonas phage phi12 NC_004175 4100 nt 5 0 5 Pseudomonas phage phi12 NC_004174 2322 nt 4 0 4 Pseudomonas phage phi13 NC_004172 6458 nt 4 0 4 Pseudomonas phage phi13 NC_004171 4213 nt 5 0 5 Pseudomonas phage phi13 NC_004170 2981 nt 4 0 4 Pseudomonas phage phi6 NC_003715 6374 nt 4 0 4 Pseudomonas phage phi6 NC_003716 4063 nt 4 0 4 Pseudomonas phage phi6 NC_003714 2948 nt 5 0 5 Pseudomonas phage phi8 NC_003299 7051 nt 7 0 7 Pseudomonas phage phi8 NC_003300 4741 nt 6 0 6 Pseudomonas phage phi8 NC_003301 3192 nt 6 0 6 Pseudomonas phage phiCTX NC_003278 35580 nt 47 0 47 Pseudomonas phage phiKMV NC_005045 42519 nt 49 0 49 Pseudomonas phage phiKZ NC_004629 280334 nt 306 0 306 Pyrobaculum spherical virus NC_005872 28337 nt 48 0 48 Pyrococcus abyssi virus 1 NC_009597 18098 nt 25 0 25 Ralstonia phage RSB1 NC_011201 43079 nt 47 0 47 Ralstonia phage RSL1 NC_010811 231256 nt 345 2 346 Ralstonia phage RSM1 NC_008574 8999 nt 15 0 15 Ralstonia phage RSM3 NC_011399 8929 nt 14 0 14 Ralstonia phage RSS1 NC_008575 6662 nt 12 0 12 Ralstonia phage p12J NC_005131 7118 nt 9 0 9 Ralstonia phage phiRSA1 NC_009382 38760 nt 51 0 51 Rhizobium phage 16-3 NC_011103 60195 nt 110 0 109 Rhodothermus phage RM378 NC_004735 129908 nt 146 0 146 Roseobacter phage SIO1 NC_002519 39898 nt 34 0 34 Salmonella phage E1 NC_010495 45051 nt 51 0 52 Salmonella phage Fels-1 NC_010391 42723 nt 52 0 52 Salmonella phage KS7 NC_006940 40794 nt 59 0 59 Salmonella phage SE1 NC_011802 41941 nt 67 0 67 Salmonella phage SETP3 NC_009232 42572 nt 53 0 53 Salmonella phage ST64B NC_004313 40149 nt 56 0 56 Salmonella phage phiSG-JL2 NC_010807 38815 nt 55 0 55 Sinorhizobium phage PBC5 NC_003324 57416 nt 83 0 83 Sodalis phage phiSG1 NC_007902 52162 nt 47 0 47 Spiroplasma kunkelii virus NC_009987 7870 nt 13 0 13 SkV1_CR2-3x Spiroplasma phage 1-C74 NC_003793 7768 nt 13 0 13 Spiroplasma phage 1-R8A2B NC_001365 8273 nt 12 0 12 Spiroplasma phage 4 NC_003438 4421 nt 9 0 9 Spiroplasma phage SVTS2 NC_001270 6825 nt 13 0 13 Sputnik virophage NC_011132 18343 nt 21 0 21 Staphylococcus aureus phage P68 NC_004679 18227 nt 22 0 22 Staphylococcus phage 11 NC_004615 43604 nt 53 0 53 Staphylococcus phage 187 NC_007047 39620 nt 77 0 77 Staphylococcus phage 2638A NC_007051 41318 nt 57 0 57 Staphylococcus phage 29 NC_007061 42802 nt 67 0 67 Staphylococcus phage 37 NC_007055 43681 nt 70 0 70 Staphylococcus phage 3A NC_007053 43095 nt 67 0 67 Staphylococcus phage 42E NC_007052 45861 nt 79 0 79 Staphylococcus phage 44AHJD NC_004678 16784 nt 21 0 21 Staphylococcus phage 47 NC_007054 44777 nt 65 0 65 Staphylococcus phage 52A NC_007062 41690 nt 60 0 60 Staphylococcus phage 53 NC_007049 43883 nt 74 0 74 Staphylococcus phage 55 NC_007060 41902 nt 77 0 77 Staphylococcus phage 66 NC_007046 18199 nt 27 0 27 Staphylococcus phage 69 NC_007048 42732 nt 69 0 69 Staphylococcus phage 71 NC_007059 43114 nt 67 0 67 Staphylococcus phage 77 NC_005356 41708 nt 69 0 69 Staphylococcus phage 80alpha NC_009526 43864 nt 73 0 73 Staphylococcus phage 85 NC_007050 44283 nt 71 0 71 Staphylococcus phage 88 NC_007063 43231 nt 66 0 66 Staphylococcus phage 92 NC_007064 42431 nt 64 0 64 Staphylococcus phage 96 NC_007057 43576 nt 74 0 74 Staphylococcus phage CNPH82 NC_008722 43420 nt 65 0 65 Staphylococcus phage EW NC_007056 45286 nt 77 0 77 Staphylococcus phage G1 NC_007066 138715 nt 214 0 214 Staphylococcus phage K NC_005880 127395 nt 115 0 115 Staphylococcus phage PH15 NC_008723 44041 nt 68 0 68 Staphylococcus phage PT1028 NC_007045 15603 nt 22 0 22 Staphylococcus phage PVL NC_002321 41401 nt 62 0 62 Staphylococcus phage ROSA NC_007058 43155 nt 74 0 74 Staphylococcus phage SAP-2 NC_009875 17938 nt 20 0 20 Staphylococcus phage Twort NC_007021 130706 nt 195 0 195 Staphylococcus phage X2 NC_007065 43440 nt 77 0 77 Staphylococcus phage phi 12 NC_004616 44970 nt 49 0 49 Staphylococcus phage phi13 NC_004617 42722 nt 49 0 49 Staphylococcus phage phi2958PVL NC_011344 47342 nt 60 0 59 Staphylococcus phage phiETA NC_003288 43081 nt 66 0 66 Staphylococcus phage phiETA2 NC_008798 43265 nt 69 0 69 Staphylococcus phage phiETA3 NC_008799 43282 nt 68 0 68 Staphylococcus phage phiMR11 NC_010147 43011 nt 67 0 67 Staphylococcus phage phiMR25 NC_010808 44342 nt 70 0 70 Staphylococcus phage phiN315 NC_004740 44082 nt 65 0 64 Staphylococcus phage phiNM NC_008583 43128 nt 64 0 64 Staphylococcus phage phiNM3 NC_008617 44061 nt 65 0 65 Staphylococcus phage phiPVL108 NC_008689 44857 nt 59 0 59 Staphylococcus phage phiSLT NC_002661 42942 nt 61 0 61 Staphylococcus phage phiSauS- NC_011612 45344 nt 62 0 62 IPLA35 Staphylococcus phage phiSauS- NC_011614 42526 nt 60 0 61 IPLA88 Staphylococcus phage tp310-1 NC_009761 41407 nt 59 0 59 Staphylococcus phage tp310-2 NC_009762 45710 nt 67 0 67 Staphylococcus phage tp310-3 NC_009763 41966 nt 58 0 58 Staphylococcus prophage phiPV83 NC_002486 45636 nt 65 0 65 Stenotrophomonas phage S1 NC_011589 40287 nt 48 0 48 Stenotrophomonas phage phiSMA9 NC_007189 6907 nt 7 0 7 Streptococcus phage 2972 NC_007019 34704 nt 44 0 44 Streptococcus phage 7201 NC_002185 35466 nt 46 0 46 Streptococcus phage 858 NC_010353 35543 nt 46 0 46 Streptococcus phage C1 NC_004814 16687 nt 20 0 20 Streptococcus phage Cp-1 NC_001825 19343 nt 25 0 25 Streptococcus phage DT1 NC_002072 34815 nt 45 0 45 Streptococcus phage EJ-1 NC_005294 42935 nt 73 0 73 Streptococcus phage MM1 NC_003050 40248 nt 53 0 53 Streptococcus phage O1205 NC_004303 43075 nt 57 0 57 Streptococcus phage P9 NC_009819 40539 nt 53 0 53 Streptococcus phage PH15 NC_010945 39136 nt 60 0 60 Streptococcus phage SM1 NC_004996 34692 nt 56 0 56 Streptococcus phage SMP NC_008721 36216 nt 48 0 48 Streptococcus phage Sfi11 NC_002214 39807 nt 53 0 53 Streptococcus phage Sfi19 NC_000871 37370 nt 45 0 45 Streptococcus phage Sfi21 NC_000872 40739 nt 50 0 50 Streptococcus phage phi3396 NC_009018 38528 nt 64 0 64 Streptococcus pyogenes phage 315.1 NC_004584 39538 nt 56 0 56 Streptococcus pyogenes phage 315.2 NC_004585 41072 nt 60 1 61 Streptococcus pyogenes phage 315.3 NC_004586 34419 nt 52 0 52 Streptococcus pyogenes phage 315.4 NC_004587 41796 nt 64 0 64 Streptococcus pyogenes phage 315.5 NC_004588 38206 nt 55 0 55 Streptococcus pyogenes phage 315.6 NC_004589 40014 nt 51 0 51 Streptomyces phage VWB NC_005345 49220 nt 61 0 61 Streptomyces phage mu1/6 NC_007967 38194 nt 52 0 52 Streptomyces phage phiBT1 NC_004664 41831 nt 55 1 56 Streptomyces phage phiC31 NC_001978 41491 nt 53 1 54 Stx1 converting phage NC_004913 59866 nt 167 0 166 Stx2 converting phage I NC_003525 61765 nt 166 0 166 Stx2 converting phage II NC_004914 62706 nt 170 0 169 Stx2-converting phage 1717 NC_011357 62147 nt 77 0 81 Stx2-converting phage 86 NC_008464 60238 nt 81 3 80 Sulfolobus islandicus filamentous NC_003214 40900 nt 73 0 73 virus Sulfolobus islandicus rod-shaped virus 1 NC_004087 32308 nt 45 0 45 Sulfolobus islandicus rod-shaped virus 2 NC_004086 35450 nt 54 0 54 Sulfolobus spindle-shaped virus 4 NC_009986 15135 nt 34 0 34 Sulfolobus spindle-shaped virus 5 NC_011217 15330 nt 34 0 34 Sulfolobus turreted icosahedral virus NC_005892 17663 nt 36 0 36 Sulfolobus virus 1 NC_001338 15465 nt 32 0 33 Sulfolobus virus 2 NC_005265 14796 nt 34 0 34 Sulfolobus virus Kamchatka 1 NC_005361 17385 nt 31 0 31 Sulfolobus virus Ragged Hills NC_005360 16473 nt 37 0 37 Sulfolobus virus STSV1 NC_006268 75294 nt 74 0 74 Synechococcus phage P60 NC_003390 47872 nt 80 0 80 Synechococcus phage S-PM2 NC_006820 196280 nt 236 1 238 Synechococcus phage Syn5 NC_009531 46214 nt 61 0 61 Synechococcus phage syn9 NC_008296 177300 nt 226 6 232 Temperate phage phiNIH1.1 NC_003157 41796 nt 55 0 55 Thalassomonas phage BA3 NC_009990 37313 nt 47 0 47 Thermoproteus tenax spherical virus 1 NC_006556 20933 nt 38 0 38 Thermus phage IN93 NC_004462 19603 nt 40 0 32 Thermus phage P23-45 NC_009803 84201 nt 117 0 117 Thermus phage P74-26 NC_009804 83319 nt 116 0 116 Thermus phage phiYS40 NC_008584 152372 nt 170 3 170 Vibrio phage K139 NC_003313 33106 nt 44 0 44 Vibrio phage KSF-1phi NC_006294 7107 nt 12 0 12 Vibrio phage KVP40 NC_005083 244834 nt 381 29 415 Vibrio phage VGJphi NC_004736 7542 nt 13 0 13 Vibrio phage VHML NC_004456 43198 nt 57 0 57 Vibrio phage VP2 NC_005879 39853 nt 47 0 47 Vibrio phage VP5 NC_005891 39786 nt 48 0 48 Vibrio phage VP882 NC_009016 38197 nt 71 0 71 Vibrio phage VSK NC_003327 6882 nt 14 0 14 Vibrio phage Vf12 NC_005949 7965 nt 7 0 7 Vibrio phage Vf33 NC_005948 7965 nt 7 0 7 Vibrio phage VfO3K6 NC_002362 8784 nt 10 0 10 Vibrio phage VfO4K68 NC_002363 6891 nt 8 0 8 Vibrio phage fs1 NC_004306 6340 nt 15 0 15 Vibrio phage fs2 NC_001956 8651 nt 9 0 9 Vibrio phage kappa NC_010275 33134 nt 45 0 45 Vibriophage VP4 NC_007149 39503 nt 31 0 31 Vibriophage VpV262 NC_003907 46012 nt 67 0 67 Xanthomonas phage Cf1c NC_001396 7308 nt 9 0 9 Xanthomonas phage OP1 NC_007709 43785 nt 59 0 59 Xanthomonas phage OP2 NC_007710 46643 nt 62 0 62 Xanthomonas phage Xop411 NC_009543 44520 nt 58 0 58 Xanthomonas phage Xp10 NC_004902 44373 nt 60 0 60 Xanthomonas phage Xp15 NC_007024 55770 nt 84 0 84 Yersinia pestis phage phiA1122 NC_004777 37555 nt 50 0 50 Yersinia phage Berlin NC_008694 38564 nt 45 0 45 Yersinia phage L-413C NC_004745 30728 nt 40 0 40 Yersinia phage PY54 NC_005069 46339 nt 67 0 66 Yersinia phage Yepe2 NC_011038 38677 nt 46 0 46 Yersinia phage phiYeO3-12 NC_001271 39600 nt 59 0 59

TABLE 6 Examples of promoters which can be operatively linked to the nucleic acid in the engineered bacteriophages. Table 6: Examples of promoters which can be operatively linked to the nucleic acid in the engineered bacteriophages. Name Description Length BBa_I0500 Inducible pBad/araC promoter 1210 BBa_I13453 Pbad promoter 130 BBa_I712004 CMV promoter 654 BBa_I712074 T7 promoter (strong promoter from T7 bacteriophage) 46 BBa_I714889 OR21 of PR and PRM 101 BBa_I714924 RecA_DlexO_DLacO1 862 BBa_I714927 RecA_S_WTlexO_DLacO 862 BBa_I714929 RecA_S_WTlexO_DLacO3 862 BBa_I714930 RecA_D_consenLexO_lacO1 862 BBa_I714933 WT_sulA_Single_LexO_double_LacO1 884 BBa_I714935 WT_sulA_Single_LexO_double_LacO2 884 BBa_I714936 WT_sulA_Single_LexO_double_LacO3 884 BBa_I714937 sluA_double_lexO_LacO1 884 BBa_I714938 sluA_double_lexO_LacO2 884 BBa_I714939 sluA_double_lexO_LacO3 884 BBa_I715038 pLac-RBS-T7 RNA Polymerase 2878 BBa_I716014 yfbE solo trial 2 302 BBa_I716102 pir (Induces the R6K Origin) 918 BBa_I719005 T7 Promoter 23 BBa_I732205 NOT Gate Promoter Family Member (D001O55) 124 BBa_J13002 TetR repressed POPS/RIPS generator 74 BBa_J13023 3OC6HSL + LuxR dependent POPS/RIPS generator 117 BBa_J23100 constitutive promoter family member 35 BBa_J23101 constitutive promoter family member 35 BBa_J23102 constitutive promoter family member 35 BBa_J23103 constitutive promoter family member 35 BBa_J23104 constitutive promoter family member 35 BBa_J23105 constitutive promoter family member 35 BBa_J23106 constitutive promoter family member 35 BBa_J23107 constitutive promoter family member 35 BBa_J23108 constitutive promoter family member 35 BBa_J23109 constitutive promoter family member 35 BBa_J23110 constitutive promoter family member 35 BBa_J23111 constitutive promoter family member 35 BBa_J23112 constitutive promoter family member 35 BBa_J23113 constitutive promoter family member 35 BBa_J23114 constitutive promoter family member 35 BBa_J23115 constitutive promoter family member 35 BBa_J23116 constitutive promoter family member 35 BBa_J23117 constitutive promoter family member 35 BBa_J23118 constitutive promoter family member 35 BBa_J44002 pBAD reverse 130 BBa_J52010 NFkappaB-dependent promoter 814 BBa_J52034 CMV promoter 654 BBa_J61043 [fdhF2] Promoter 269 BBa_J63005 yeast ADH1 promoter 1445 BBa_J63006 yeast GAL1 promoter 549 BBa_K082017 general recombine system 89 BBa_K091110 LacI Promoter 56 BBa_K091111 LacIQ promoter 56 BBa_K094120 pLacI/ara-1 103 BBa_K100000 Natural Xylose Regulated Bi-Directional Operator 303 BBa_K100001 Edited Xylose Regulated Bi-Directional Operator 1 303 BBa_K100002 Edited Xylose Regulated Bi-Directional Operator 2 303 BBa_K118011 PcstA (glucose-repressible promoter) 131 BBa_K135000 pCpxR (CpxR responsive promoter) 55 BBa_K137029 constitutive promoter with (TA)10 between-10 and -35 39 elements BBa_K137030 constitutive promoter with (TA)9 between-10 and -35 37 elements BBa_K137046 150 bp inverted tetR promoter 150 BBa_K137047 250 bp inverted tetR promoter 250 BBa_K137048 350 bp inverted tetR promoter 350 BBa_K137049 450 bp inverted tetR promoter 450 BBa_K137050 650 bp inverted tetR promoter 650 BBa_K137051 850 bp inverted tetR promoter 850 BBa_R0010 promoter (lacI regulated) 200 BBa_R0011 Promoter (lacI regulated, lambda pL hybrid) 55 BBa_R0053 Promoter (p22 cII regulated) 54 BBa_I1010 cI(1) fused to tetR promoter 834 BBa_I1051 Lux cassette right promoter 68 BBa_I12006 Modified lamdba Prm promoter (repressed by 434 cI) 82 BBa_I12036 Modified lamdba Prm promoter (cooperative repression by 434 91 cI) BBa_I12040 Modified lambda P(RM) promoter: -10 region from P(L) and 91 cooperatively repressed by 434 cI BBa_I13005 Promoter R0011 w/ YFP (−LVA) TT 920 BBa_I13006 Promoter R0040 w/ YFP (−LVA) TT 920 BBa_I14015 P(Las) TetO 170 BBa_I14016 P(Las) CIO 168 BBa_I14017 P(Rhl) 51 BBa_I14018 P(Bla) 35 BBa_I14033 P(Cat) 38 BBa_I14034 P(Kat) 45 BBa_I714890 OR321 of PR and PRM 121 BBa_I714925 RecA_DlexO_DLacO2 862 BBa_I714926 RecA_DlexO_DLacO3 862 BBa_I714928 RecA_S_WTlexO_DLacO2 862 BBa_I714931 RecA_D_consenLexO_lacO2 862 BBa_I718018 dapAp promoter 81 BBa_I720001 AraBp->rpoN 1632 BBa_I720002 glnKp->lacI 1284 BBa_I720003 NifHp->cI (lambda) 975 BBa_I720005 NifA lacI RFP 3255 BBa_I720006 GFP glnG cI 2913 BBa_I720007 araBp->rpoN (leucine landing pad) 51 BBa_I720008 Ara landing pad (pBBLP 6) 20 BBa_I720009 Ara landing pad (pBBLP 7) 23 BBa_I720010 Ara landing pad (pBBLP 8) 20 BBa_I721001 Lead Promoter 94 BBa_I723020 Pu 320 BBa_I728456 MerRT: Mercury-Inducible Promoter + RBS (MerR + part of 635 MerT) BBa_I741018 Right facing promoter (for xylF) controlled by xylR and CRP- 221 cAMP BBa_I742124 Reverse complement Lac promoter 203 BBa_I746104 P2 promoter in agr operon from S. aureus 96 BBa_I746360 PF promoter from P2 phage 91 BBa_I746361 PO promoter from P2 phage 92 BBa_I746362 PP promoter from P2 phage 92 BBa_I746364 Psid promoter from P4 phage 93 BBa_I746365 PLL promoter from P4 phage 92 BBa_I748001 Putative Cyanide Nitrilase Promoter 271 BBa_I752000 Riboswitch(theophylline) 56 BBa_I761011 CinR, CinL and glucose controlled promotor 295 BBa_I761014 cinr + cinl (RBS) with double terminator 1661 BBa_I764001 Ethanol regulated promoter AOX1 867 BBa_I765000 Fe promoter 1044 BBa_I765001 UV promoter 76 BBa_I765007 Fe and UV promoters 1128 BBa_J13210 pOmpR dependent POPS producer 245 BBa_J22106 rec A (SOS) Promoter 192 BBa_J23119 constitutive promoter family member 35 BBa_J24669 Tri-Stable Toggle (Arabinose induced component) 3100 BBa_J3902 PrFe (PI + PII rus operon) 272 BBa_J58100 AND-type promoter synergistically activated by cI and CRP 106 BBa_J61051 [Psal1] 1268 BBa_K085005 (lacI)promoter->key3c->Terminator 405 BBa_K088007 GlnRS promoter 38 BBa_K089004 phaC Promoter (−663 from ATG) 663 BBa_K089005 −35 to Tc start site of phaC 49 BBa_K089006 −663 to Tc start site of phaC 361 BBa_K090501 Gram-Positive IPTG-Inducible Promoter 107 BBa_K090504 Gram-Positive Strong Constitutive Promoter 239 BBa_K091100 pLac_lux hybrid promoter 74 BBa_K091101 pTet_Lac hybrid promoter 83 BBa_K091104 pLac/Mnt Hybrid Promoter 87 BBa_K091105 pTet/Mnt Hybrid Promoter 98 BBa_K091106 LsrA/cI hybrid promoter 141 BBa_K091107 pLux/cI Hybrid Promoter 57 BBa_K091114 LsrAR Promoter 248 BBa_K091115 LsrR Promoter 100 BBa_K091116 LsrA Promoter 126 BBa_K091117 pLas promoter 126 BBa_K091143 pLas/cI Hybrid Promoter 164 BBa_K091146 pLas/Lux Hybrid Promoter 126 BBa_K091184 pLux/cI + RBS + LuxS + RBS + Mnt + TT + pLac/Mnt + RBS + LuxS + 2616 RBS + cI + TT BBa_K093000 pRecA with LexA binding site 48 BBa_K101017 MioC Promoter (DNAa-Repressed Promoter) 319 BBa_K101018 MioC Promoter (regulating tetR) 969 BBa_K105020 tetR - operator 29 BBa_K105021 cI - operator 27 BBa_K105022 lex A - operator 31 BBa_K105023 lac I - operator 25 BBa_K105024 Gal4 - operator 27 BBa_K105026 Gal1 promoter 549 BBa_K105027 cyc100 minimal promoter 103 BBa_K105028 cyc70 minimal promoter 103 BBa_K105029 cyc43 minimal promoter 103 BBa_K105030 cyc28 minimal promoter 103 BBa_K105031 cyc16 minimal promoter 103 BBa_K108014 PR 234 BBa_K108016 PP 406 BBa_K108025 Pu 200 BBa_K109200 AraC and TetR promoter (hybrid) 132 BBa_K110005 Alpha-Cell Promoter MF(ALPHA)2 500 BBa_K110006 Alpha-Cell Promoter MF(ALPHA)1 501 BBa_K110016 A-Cell Promoter STE2 (backwards) 500 BBa_K112118 rrnB P1 promoter 503 BBa_K112318 {<bolA promoter>} in BBb format 436 BBa_K112319 {<ftsQ promoter>} in BBb format 434 BBa_K112320 {<ftsAZ promoter>} in BBb format 773 BBa_K112322 {Pdps} in BBb format 348 BBa_K112323 {H-NS!} in BBb format 414 BBa_K112400 Promoter for grpE gene - Heat Shock and Ultrasound Sensitive 98 BBa_K112401 Promoter for recA gene - SOS and Ultrasound Sensitive 286 BBa_K112402 promoter for FabA gene - Membrane Damage and Ultrasound 256 Senstitive BBa_K112405 Promoter for CadA and CadB genes 370 BBa_K112406 cadC promoter 2347 BBa_K112407 Promoter for ygeF psuedogene 494 BBa_K113009 pBad/araC 1210 BBa_K116001 nhaA promoter, that can be regulated by pH and nhaR protein. 274 BBa_K116401 external phosphate sensing promoter 506 BBa_K116500 OmpF promoter that is activated or repressesed by OmpR 126 according to osmolarity. BBa_K116603 pRE promoter from λ phage 48 BBa_K117002 LsrA promoter (indirectly activated by AI-2) 102 BBa_K117004 pLacI-GFP 1086 BBa_K117005 pLacI-RBS 220 BBa_K119002 RcnR operator (represses RcnA) 83 BBa_K122000 pPGK1 1497 BBa_K122002 pADH1 (truncated) 701 BBa_K123002 LacIQ ERE TetR 742 BBa_K123003 ER 1849 BBa_K125110 nir promoter + rbs (0.6) 111 BBa_K128006 L. bulgaricus LacS Promoter 197 BBa_K133044 TetR(RBS) 35 BBa_K136006 flgA promoter followed by its natural RBS 202 BBa_K136008 flhB promoter followed by its natural RBS 203 BBa_K136009 fliL promoter followed by its natural RBS 154 BBa_K136010 fliA promoter 345 BBa_K137031 constitutive promoter with (C)10 between −10 and −35 elements 62 BBa_K137032 constitutive promoter with (C)12 between −10 and −35 elements 64 BBa_K137125 LacI-repressed promoter B4 103 BBa_K145150 Hybrid promoter: HSL-LuxR activated, P22 C2 repressed 66 BBa_K149001 Prp22 promoter 1006 BBa_K165001 pGAL1 + w/XhoI sites 672 BBa_K165011 Zif268-HIV binding sites (3) 46 BBa_K165012 Gli1 binding sites 127 BBa_K165013 YY1 binding sites 51 BBa_K165016 mCYC1 minimal yeast promoter 245 BBa_K165030 mCYC promoter plus Zif268-HIV binding sites 307 BBa_K165031 mCYC promoter plus LexA binding sites 403 BBa_K165032 mCYC promoter plus Gli1 binding sites 411 BBa_K165033 YY1 binding sites + mCYC promoter 304 BBa_K165034 Zif268-HIV bs + LexA bs + mCYC promoter 457 BBa_K165035 Gli1 bs + Zif268-HIV bs + mCYC promoter 442 BBa_K165036 Gli1 bs + LexA bs + mCYC promoter 538 BBa_K165038 Gli1 binding sites + ADH1 constitutive yeast promoter 1580 BBa_K165039 Zif268-HIV binding sites + ADH1 yeast promoter 1499 BBa_K165040 Gli1 binding sites + TEF constitutive yeast promoter 538 BBa_K165041 Zif268-HIV binding sites + TEF constitutive yeast promoter 457 BBa_K165042 Gli1 binding sites + MET25 inducible yeast promoter 522 BBa_K165043 Zif268-HIV binding sites + MET25 constitutive yeast 441 promoter BBa_K165045 pGAL1 + LexA bindingsites 785 BBa_K165048 LexA op8 mCYC1 393 BBa_R0050 Promoter (HK022 cI regulated) 55 BBa_R0052 Promoter (434 cI regulated) 46 BBa_R0061 Promoter (HSL-mediated luxR repressor) 30 BBa_R0063 Promoter (luxR & HSL regulated -- lux pL) 151 BBa_R0065 Promoter (lambda cI and luxR regulated -- hybrid) 97 BBa_R0071 Promoter (RhlR & C4-HSL regulated) 53 BBa_R0073 Promoter (Mnt regulated) 67 BBa_R0074 Promoter (PenI regulated) 77 BBa_R0075 Promoter (TP901 cI regulated) 117 BBa_R0077 Promoter (cinR and HSL regulated, RBS+) 231 BBa_R0078 Promoter (cinR and HSL regulated) 225 BBa_R0081 Inhibitor (AraC loop attachment with O2 site) 183 BBa_R0082 Promoter (OmpR, positive) 108 BBa_R0083 Promoter (OmpR, positive) 78 BBa_R0084 Promoter (OmpR, positive) 108 BBa_R1050 Promoter, Standard (HK022 cI regulated) 56 BBa_R1051 Promoter, Standard (lambda cI regulated) 49 BBa_R1052 Promoter, Standard (434 cI regulated) 46 BBa_R1053 Promoter, Standard (p22 cII regulated) 55 BBa_R1062 Promoter, Standard (luxR and HSL regulated -- lux pR) 56 BBa_R2000 Promoter, Zif23 regulated, test: between 45 BBa_R2001 Promoter, Zif23 regulated, test: after 52 BBa_R2002 Promoter, Zif23 regulated, test: between and after 52 BBa_R2109 Promoter with operator site for C2003 72 BBa_R2114 Promoter with operator site for C2003 72 BBa_I10498 Oct-4 promoter 1417 BBa_I12001 Promoter (PRM+) 96 BBa_I12003 Lambda Prm Promoter 88 BBa_I12005 lambda Prm Inverted Antisense (No start codon) 85 BBa_I12008 Barkai-Leibler design experiment part A (p22cII) 1154 BBa_I12010 Modified lamdba Prm promoter (repressed by p22 cII) 78 BBa_I12014 Repressor, 434 cI (RBS−LVA−) 636 BBa_I12021 Inducible Lambda cI Repressor Generator (Controlled by IPTG 2370 and LacI) BBa_I12031 Barkai-Leibler design experiment Part A (Lambda cI) wth 1159 cooperativity BBa_I12032 Modified lamdba Prm promoter (repressed by p22 cI with 106 cooperativity) RBS+ BBa_I12034 Modified lamdba Prm promoter (repressed by 434 cI with 102 cooperativity) RBS+ BBa_I12035 Modified lamdba Prm promoter (repressed by p22 cI without 106 cooperativity) RBS+ BBa_I12037 Reporter 3 for Barkai-Leibler oscillator 1291 BBa_I12044 Activator for BL oscillator with reporter protein, 2112 (cooperativity) BBa_I12045 BL oscillator, cooperativity, reporter protein, kickstart 4139 BBa_I12046 Activator for BL oscillator with reporter protein, (cooperativity 2112 and L-strain −10 region) BBa_I12047 BL oscillator, cooperativity + replaced −10 region (Llac), 4139 reporter protein, kickstart BBa_I12210 plac Or2-62 (positive) 70 BBa_I12212 TetR - TetR-4C heterodimer promoter (negative) 61 BBa_I12219 Wild-type TetR(B) promoter (negative) 71 BBa_I13062 LuxR QPI 822 BBa_I13267 Intermediate part from assembly 317 1769 BBa_I13406 Pbad/AraC with extra REN sites 1226 BBa_I14021 plTetO1.RBS.CinI 810 BBa_I20255 Promoter-RBS 57 BBa_I20256 Promoter-RBS 56 BBa_I20258 Promoter-RBS 56 BBa_I714932 RecA_D_consenLexO_lacO3 862 BBa_I715003 hybrid pLac with UV5 mutation 55 BBa_I715052 Trp Leader Peptide and anti-terminator/terminator 134 BBa_I715053 Trp Leader Peptide and anti-terminator/terminator with hixC 159 insertion BBa_I717002 Pr from lambda switch 177 BBa_I723011 pDntR (estimated promoter for DntR) 26 BBa_I723013 pDntA (estimated promoter for DntA) 33 BBa_I723018 Pr (promoter for XylR) 410 BBa_I731004 FecA promoter 90 BBa_I732021 Template for Building Primer Family Member 159 BBa_I732200 NOT Gate Promoter Family Member (D001O1wt1) 125 BBa_I732201 NOT Gate Promoter Family Member (D001O11) 124 BBa_I732202 NOT Gate Promoter Family Member (D001O22) 124 BBa_I732203 NOT Gate Promoter Family Member (D001O33) 124 BBa_I732204 NOT Gate Promoter Family Member (D001O44) 124 BBa_I732206 NOT Gate Promoter Family Member (D001O66) 124 BBa_I732207 NOT Gate Promoter Family Member (D001O77) 124 BBa_I732270 Promoter Family Member with Hybrid Operator (D001O12) 124 BBa_I732271 Promoter Family Member with Hybrid Operator (D001O16) 124 BBa_I732272 Promoter Family Member with Hybrid Operator (D001O17) 124 BBa_I732273 Promoter Family Member with Hybrid Operator (D001O21) 124 BBa_I732274 Promoter Family Member with Hybrid Operator (D001O24) 124 BBa_I732275 Promoter Family Member with Hybrid Operator (D001O26) 124 BBa_I732276 Promoter Family Member with Hybrid Operator (D001O27) 124 BBa_I732277 Promoter Family Member with Hybrid Operator (D001O46) 124 BBa_I732278 Promoter Family Member with Hybrid Operator (D001O47) 124 BBa_I732279 Promoter Family Member with Hybrid Operator (D001O61) 124 BBa_I732301 NAND Candidate (U073O26D001O16) 120 BBa_I732302 NAND Candidate (U073O27D001O17) 120 BBa_I732303 NAND Candidate (U073O22D001O46) 120 BBa_I732304 NAND Candidate (U073O22D001O47) 120 BBa_I732305 NAND Candidate (U073O22D059O46) 178 BBa_I732306 NAND Candidate (U073O11D002O22) 121 BBa_I732351 NOR Candidate (U037O11D002O22) 85 BBa_I732352 NOR Candidate (U035O44D001O22) 82 BBa_I732400 Promoter Family Member (U097NUL + D062NUL) 165 BBa_I732401 Promoter Family Member (U097O11 + D062NUL) 185 BBa_I732402 Promoter Family Member (U085O11 + D062NUL) 173 BBa_I732403 Promoter Family Member (U073O11 + D062NUL) 161 BBa_I732404 Promoter Family Member (U061O11 + D062NUL) 149 BBa_I732405 Promoter Family Member (U049O11 + D062NUL) 137 BBa_I732406 Promoter Family Member (U037O11 + D062NUL) 125 BBa_I732407 Promoter Family Member (U097NUL + D002O22) 125 BBa_I732408 Promoter Family Member (U097NUL + D014O22) 137 BBa_I732409 Promoter Family Member (U097NUL + D026O22) 149 BBa_I732410 Promoter Family Member (U097NUL + D038O22) 161 BBa_I732411 Promoter Family Member (U097NUL + D050O22) 173 BBa_I732412 Promoter Family Member (U097NUL + D062O22) 185 BBa_I732413 Promoter Family Member (U097O11 + D002O22) 145 BBa_I732414 Promoter Family Member (U097O11 + D014O22) 157 BBa_I732415 Promoter Family Member (U097O11 + D026O22) 169 BBa_I732416 Promoter Family Member (U097O11 + D038O22) 181 BBa_I732417 Promoter Family Member (U097O11 + D050O22) 193 BBa_I732418 Promoter Family Member (U097O11 + D062O22) 205 BBa_I732419 Promoter Family Member (U085O11 + D002O22) 133 BBa_I732420 Promoter Family Member (U085O11 + D014O22) 145 BBa_I732421 Promoter Family Member (U085O11 + D026O22) 157 BBa_I732422 Promoter Family Member (U085O11 + D038O22) 169 BBa_I732423 Promoter Family Member (U085O11 + D050O22) 181 BBa_I732424 Promoter Family Member (U085O11 + D062O22) 193 BBa_I732425 Promoter Family Member (U073O11 + D002O22) 121 BBa_I732426 Promoter Family Member (U073O11 + D014O22) 133 BBa_I732427 Promoter Family Member (U073O11 + D026O22) 145 BBa_I732428 Promoter Family Member (U073O11 + D038O22) 157 BBa_I732429 Promoter Family Member (U073O11 + D050O22) 169 BBa_I732430 Promoter Family Member (U073O11 + D062O22) 181 BBa_I732431 Promoter Family Member (U061O11 + D002O22) 109 BBa_I732432 Promoter Family Member (U061O11 + D014O22) 121 BBa_I732433 Promoter Family Member (U061O11 + D026O22) 133 BBa_I732434 Promoter Family Member (U061O11 + D038O22) 145 BBa_I732435 Promoter Family Member (U061O11 + D050O22) 157 BBa_I732436 Promoter Family Member (U061O11 + D062O22) 169 BBa_I732437 Promoter Family Member (U049O11 + D002O22) 97 BBa_I732438 Promoter Family Member (U049O11 + D014O22) 109 BBa_I732439 Promoter Family Member (U049O11 + D026O22) 121 BBa_I732440 Promoter Family Member (U049O11 + D038O22) 133 BBa_I732441 Promoter Family Member (U049O11 + D050O22) 145 BBa_I732442 Promoter Family Member (U049O11 + D062O22) 157 BBa_I732443 Promoter Family Member (U037O11 + D002O22) 85 BBa_I732444 Promoter Family Member (U037O11 + D014O22) 97 BBa_I732445 Promoter Family Member (U037O11 + D026O22) 109 BBa_I732446 Promoter Family Member (U037O11 + D038O22) 121 BBa_I732447 Promoter Family Member (U037O11 + D050O22) 133 BBa_I732448 Promoter Family Member (U037O11 + D062O22) 145 BBa_I732450 Promoter Family Member (U073O26 + D062NUL) 161 BBa_I732451 Promoter Family Member (U073O27 + D062NUL) 161 BBa_I732452 Promoter Family Member (U073O26 + D062O61) 181 BBa_I735008 ORE1X Oleate response element 273 BBa_I735009 ORE2X oleate response element 332 BBa_I735010 This promoter encoding for a thiolase involved in beta- 850 oxidation of fatty acids. BBa_I739101 Double Promoter (constitutive/TetR, negative) 83 BBa_I739102 Double Promoter (cI, negative/TetR, negative) 97 BBa_I739103 Double Promoter (lacI, negative/P22 cII, negative) 87 BBa_I739104 Double Promoter (LuxR/HSL, positive/P22 cII, negative) 101 BBa_I739105 Double Promoter (LuxR/HSL, positive/cI, negative) 99 BBa_I739106 Double Promoter (TetR, negative/P22 cII, negative) 84 BBa_I739107 Double Promoter (cI, negative/LacI, negative) 78 BBa_I741015 two way promoter controlled by XylR and Crp-CAmp 301 BBa_I741017 dual facing promoter controlled by xylR and CRP-cAMP 302 (I741015 reverse complement) BBa_I741019 Right facing promoter (for xylA) controlled by xylR and CRP- 131 cAMP BBa_I741020 promoter to xylF without CRP and several binding sites for 191 xylR BBa_I741021 promoter to xylA without CRP and several binding sites for 87 xylR BBa_I741109 Lambda Or operator region 82 BBa_I742126 Reverse lambda cI-regulated promoter 49 BBa_I746363 PV promoter from P2 phage 91 BBa_I746665 Pspac-hy promoter 58 BBa_I751500 pcI (for positive control of pcI-lux hybrid promoter) 77 BBa_I751501 plux-cI hybrid promoter 66 BBa_I751502 plux-lac hybrid promoter 74 BBa_I756002 Kozak Box 7 BBa_I756014 LexAoperator-MajorLatePromoter 229 BBa_I756015 CMV Promoter with lac operator sites 663 BBa_I756016 CMV-tet promoter 610 BBa_I756017 U6 promoter with tet operators 341 BBa_I756018 Lambda Operator in SV-40 intron 411 BBa_I756019 Lac Operator in SV-40 intron 444 BBa_I756020 Tet Operator in SV-40 intron 391 BBa_I756021 CMV promoter with Lambda Operator 630 BBa_I760005 Cu-sensitive promoter 16 BBa_I761000 cinr + cinl (RBS) 1558 BBa_I761001 OmpR binding site 62 BBa_I766200 pSte2 1000 BBa_I766214 pGal1 1002 BBa_I766555 pCyc (Medium) Promoter 244 BBa_I766556 pAdh (Strong) Promoter 1501 BBa_I766557 pSte5 (Weak) Promoter 601 BBa_I766558 pFig1 (Inducible) Promoter 1000 BBa_I9201 lambda cI operator/binding site 82 BBa_J01005 pspoIIE promoter (spo0A J01004, positive) 206 BBa_J01006 Key Promoter absorbs 3 59 BBa_J03007 Maltose specific promotor 206 BBa_J03100 -- No description -- 847 BBa_J04700 Part containing promoter, riboswitch mTCT8-4 theophylline 258 aptamer (J04705), and RBS BBa_J04705 Riboswitch designed to turn “ON” a protein 38 BBa_J04800 J04800 (RevAptRibo) contains a theophylline aptamer 258 upstream of the RBS that should act as a riboswi BBa_J04900 Part containing promoter, 8 bp, RBS, and riboswitch mTCT8-4 258 theophylline aptamer (J04705) BBa_J05209 Modifed Pr Promoter 49 BBa_J05210 Modifed Prm+ Promoter 82 BBa_J05215 Regulator for R1-CREBH 41 BBa_J05216 Regulator for R3-ATF6 41 BBa_J05217 Regulator for R2-YAP7 41 BBa_J05218 Regulator for R4-cMaf 41 BBa_J05221 Tripple Binding Site for R3-ATF6 62 BBa_J05222 ZF-2*e2 Binding Site 37 BBa_J05500 Sensing Device A (cI) 2371 BBa_J05501 Sensing Device B (cI + LVA) 2337 BBa_J06403 RhIR promoter repressible by CI 51 BBa_J07007 ctx promoter 145 BBa_J07010 ToxR_inner (aa's 1-198; cytoplasm + TM) 594 BBa_J07019 FecA Promoter (with Fur box) 86 BBa_J07041 POPS/RIPS generator (R0051::B0030) 72 BBa_J07042 POPS/RIPS generator (R0040::B0030) 77 BBa_J11003 control loop for PI controller with BBa_J11002 961 BBa_J13211 R0040.B0032 75 BBa_J13212 R0040.B0033 73 BBa_J15301 Pars promoter from Escherichia coli chromosomal ars operon. 127 BBa_J15502 copA promoter 287 BBa_J16101 BanAp - Banana-induced Promoter 19 BBa_J16105 HelPp - “Help” Dependant promoter 26 BBa_J16400 Iron sensitive promoter (test delete later) 26 BBa_J21002 Promoter + LuxR 998 BBa_J21003 Promoter + TetR 904 BBa_J21004 Promoter + LacL 1372 BBa_J21006 LuxR, TetR Generator 1910 BBa_J21007 LuxR, TetR, LacL Generator 3290 BBa_J22052 Pcya 65 BBa_J22086 pX (DnaA binding site) 125 BBa_J22126 Rec A (SOS) promoter 186 BBa_J23150 1bp mutant from J23107 35 BBa_J23151 1bp mutant from J23114 35 BBa_J24000 CafAp (Cafeine Dependant promoter) 14 BBa_J24001 WigLp (Wiggle-dependent Promotor) 46 BBa_J24670 Tri-Stable Toggle (Lactose induced component) 1877 BBa_J24671 Tri-Stable Toggle (Tetracycline induced component) 2199 BBa_J24813 URA3 Promoter from S. cerevisiae 137 BBa_J26003 Mushroom Activated Promoter 23 BBa_J31013 pLac Backwards [cf. BBa_R0010] 200 BBa_J31014 crRNA 38 BBa_J3102 pBad:RBS 153 BBa_J31020 produces taRNA 295 BBa_J31022 comK transcription activator from B. subtilis 578 BBa_J33100 ArsR and Ars Promoter 472 BBa_J34800 Promoter tetracyclin inducible 94 BBa_J34806 promoter lac induced 112 BBa_J34809 promoter lac induced 125 BBa_J34814 T7 Promoter 28 BBa_J45503 hybB Cold Shock Promoter 393 BBa_J45504 htpG Heat Shock Promoter 405 BBa_J45992 Full-length stationary phase osmY promoter 199 BBa_J45993 Minimal stationary phase osmY promoter 57 BBa_J45994 Exponential phase transcriptional control device 1109 BBa_J48103 Iron promoter 140 BBa_J48104 NikR promoter, a protein of the ribbon helix-helix family of 40 trancription factors that repress expre BBa_J48106 vnfH 891 BBa_J48107 UGT008-3 Promoter/Met32p 588 BBa_J48110 Fe Promoter+ mRFP1 1009 BBa_J48111 E. coli NikR 926 BBa_J48112 vnfH: vanadium promoter 1816 BBa_J49000 Roid Rage 4 BBa_J49001 Testosterone dependent promoter for species Bicyclus Bicyclus 89 BBa_J49006 Nutrition Promoter 3 BBa_J4906 WrooHEAD2 (Wayne Rooney's Head dependent promoter) 122 BBa_J54015 Protein Binding Site_LacI 42 BBa_J54016 promoter_lacq 54 BBa_J54017 promoter_always 98 BBa_J54018 promoter_always 98 BBa_J54101 deltaP-GFP(A) BBa_J54102 DeltaP-GFP(A) 813 BBa_J54110 MelR_regulated promoter 76 BBa_J54120 EmrR_regulated promoter 46 BBa_J54130 BetI_regulated promoter 46 BBa_J54200 lacq_Promoter 50 BBa_J54210 RbsR_Binding_Site 37 BBa_J54220 FadR_Binding_Site 34 BBa_J54230 TetR_regulated 38 BBa_J54250 LacI_Binding_Site 42 BBa_J56012 Invertible sequence of dna includes Ptrc promoter 409 BBa_J56015 lacIQ - promoter sequence 57 BBa_J61045 [spv] spv operon (PoPS out) 1953 BBa_J61054 [HIP-1] Promoter 53 BBa_J61055 [HIP-1fnr] Promoter 53 BBa_J64000 rhlI promoter 72 BBa_J64001 psicA from Salmonella 143 BBa_J64010 lasI promoter 53 BBa_J64065 cI repressed promoter 74 BBa_J64067 LuxR + 3OC6HSL independent R0065 98 BBa_J64068 increased strength R0051 49 BBa_J64069 R0065 with lux box deleted 84 BBa_J64700 Trp Operon Promoter 616 BBa_J64712 LasR/LasI Inducible & RHLR/RHLI repressible Promoter 157 BBa_J64750 SPI-1 TTSS secretion-linked promoter from Salmonella 167 BBa_J64800 RHLR/RHLI Inducible & LasR/LasI repressible Promoter 53 BBa_J64804 The promoter region (inclusive of regulator binding sites) of 135 the B. subtilis RocDEF operon BBa_J64931 glnKp promoter 147 BBa_J64951 E. Coli CreABCD phosphate sensing operon promoter 81 BBa_J64979 glnAp2 151 BBa_J64980 OmpR-P strong binding, regulatory region for Team Challenge03-2007 BBa_J64981 OmpR-P strong binding, regulatory region for Team 82 Challenge03-2007 BBa_J64982 OmpR-P strong binding, regulatory region for Team Challenge 25 03-2007 BBa_J64983 Strong OmpR Binding Site 20 BBa_J64986 LacI Consensus Binding Site 20 BBa_J64987 LacI Consensus Binding Site in sigma 70 binding region 32 BBa_J64991 TetR 19 BBa_J64995 Phage-35 site 6 BBa_J64997 T7 consensus-10 and rest 19 BBa_J64998 consensus-10 and rest from SP6 19 BBa_J70025 Promoter for tetM gene, from pBOT1 plasmid, pAMbeta1 345 BBa_J72005 {Ptet} promoter in BBb 54 BBa_K076017 Ubc Promoter 1219 BBa_K078101 aromatic compounds regulatory pcbC promoter 129 BBa_K079017 Lac symmetric - operator library member 20 BBa_K079018 Lac 1 - operator library member 21 BBa_K079019 Lac 2 - operator library member 21 BBa_K079036 Tet O operator library member 15 BBa_K079037 TetO-4C - operator library member 15 BBa_K079038 TetO-wt/4C5G - operator library member 15 BBa_K079039 LexA 1 - operaor library member 16 BBa_K079040 LexA 2 - opeartor library member 16 BBa_K079041 Lambda OR1 - operator library member 17 BBa_K079042 Lambda OR2 - operator library member 17 BBa_K079043 Lambda OR3 - operator library member 17 BBa_K079045 Lac operator library 78 BBa_K079046 Tet operator library 61 BBa_K079047 Lambda operator library 67 BBa_K079048 LexA operator library 40 BBa_K080000 TCFbs-BMP4 1582 BBa_K080001 A20/alpha cardiac actin miniPro-BMP4 1402 BBa_K080003 CMV-rtTA 1413 BBa_K080005 TetO (TRE)-nkx2.5-fmdv2A-dsRed 2099 BBa_K080006 TetO (TRE)-gata4-fmdv2A-dsRed 2447 BBa_K080008 TetO (TRE)-nkx-2.5-fmdv2A-gata4-fmdv2A-dsRed 3497 BBa_K085004 riboswitch system with GFP 1345 BBa_K085006 pTet->lock3d->GFP->Ter 932 BBa_K086017 unmodified Lutz-Bujard LacO promoter 55 BBa_K086018 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ24 BBa_K086019 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ24 BBa_K086020 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ24 BBa_K086021 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ24 BBa_K086022 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ28 BBa_K086023 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ28 BBa_K086024 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ28 BBa_K086025 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ28 BBa_K086026 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ32 BBa_K086027 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ32 BBa_K086028 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ32 BBa_K086029 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ32 BBa_K086030 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ38 BBa_K086031 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ38 BBa_K086032 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ38 BBa_K086033 modified Lutz-Bujard LacO promoter, with alternative sigma 55 factor σ38 BBa_K090502 Gram-Positive Xylose-Inducible Promoter 126 BBa_K090503 Gram-Positive General Constitutive Promoter 91 BBa_K091112 pLacIQ1 promoter 56 BBa_K091156 pLux 55 BBa_K091157 pLux/Las Hybrid Promoter 55 BBa_K093008 reverse BBa_R0011 55 BBa_K094002 plambda P(O-R12) 100 BBa_K094140 pLacIq 80 BBa_K100003 Edited Xylose Regulated Bi-Directional Operator 3 303 BBa_K101000 Dual-Repressed Promoter for p22 mnt and TetR 61 BBa_K101001 Dual-Repressed Promoter for LacI and LambdacI 116 BBa_K101002 Dual-Repressed Promoter for p22 cII and TetR 66 BBa_K102909 TA11 gate from synthetic algorithm v1.1 134 BBa_K102910 TA12 gate from synthetic algorithm v1.1 107 BBa_K102911 TA13 gate from synthetic algorithm v1.2 90 BBa_K102912 TA12 plus pause sequence 108 BBa_K102950 TA0In null anti-sense input 175 BBa_K102951 TA1In anti-sense input to TA1 (BBa_K102901) 157 BBa_K102952 TA2In anti-sense input to BBa_K102952 168 BBa_K102953 TA13n anti-sense input to TA3 (BBa_K102903) 168 BBa_K102954 TA6In anti-sense input to BBa_K102904 169 BBa_K102955 TA7In anti-sense input to BBa_K102905 168 BBa_K102956 TA8In anti-sense input to BBa_K102906 168 BBa_K102957 TA9In anti-sense input to BBa_K102907 173 BBa_K102958 TA10In anti-sense input to BBa_K102908 183 BBa_K102959 TA11In anti-sense input to BBa_K102909 178 BBa_K102960 TA12In anti-sense input to anti-terminator BBa_K102910 173 BBa_K102961 TA13In anti-sense input to BBa_K102911 171 BBa_K102962 TA14In anti-sense input to BBa_K102912 180 BBa_K103021 modified T7 promoter with His-Tag 166 BBa_K103022 Plac with operator and RBS 279 BBa_K106673 8xLexAops-Cyc1p 418 BBa_K106680 8xLexAops-Fig1P 1169 BBa_K106694 Adh1P! (Adh1 Promoter, A! end) 1511 BBa_K106699 Gal1 Promoter 686 BBa_K109584 this is a test part, disregard it BBa_K110004 Alpha-Cell Promoter Ste3 501 BBa_K110007 A-Cell Promoter MFA2 501 BBa_K110008 A-Cell Promoter MFA1 501 BBa_K110009 A-Cell Promoter STE2 501 BBa_K110014 A-Cell Promoter MFA2 (backwards) 550 BBa_K110015 A-Cell Promoter MFA1 (RtL) 436 BBa_K112139 oriR6K conditional replication origin 408 BBa_K112148 phoPp1 magnesium promoter 81 BBa_K112149 PmgtCB Magnesium promoter from Salmonella 280 BBa_K112321 {H-NS!} using MG1655 reverse oligo in BBb format 414 BBa_K112701 hns promoter 669 BBa_K112706 Pspv2 from Salmonella 474 BBa_K112707 Pspv from Salmonella 1956 BBa_K112708 PfhuA 210 BBa_K112711 rbs.spvR! 913 BBa_K112900 Pbad 1225 BBa_K112904 PconB5 41 BBa_K112905 PconC5 41 BBa_K112906 PconG6 41 BBa_K112907 Pcon 41 BBa_K113010 overlapping T7 promoter 40 BBa_K113011 more overlapping T7 promoter 37 BBa_K113012 weaken overlapping T7 promoter 40 BBa_K116201 ureD promoter from P mirabilis BBa_K119000 Constitutive weak promoter of lacZ 38 BBa_K119001 Mutated LacZ promoter 38 BBa_K120010 Triple_lexO 114 BBa_K120023 lexA_DBD 249 BBa_K121011 promoter (lacI regulated) 232 BBa_K121014 promoter (lambda cI regulated) 90 BBa_K124000 pCYC Yeast Promoter 288 BBa_K124002 Yeast GPD (TDH3) Promoter 681 BBa_K125100 nir promoter from Synechocystis sp. PCC6803 88 BBa_K131017 p_qrr4 from Vibrio harveyi 275 BBa_K137085 optimized (TA) repeat constitutive promoter with 13 bp 31 between-10 and -35 elements BBa_K137086 optimized (TA) repeat constitutive promoter with 15 bp 33 between-10 and -35 elements BBa_K137087 optimized (TA) repeat constitutive promoter with 17 bp 35 between-10 and -35 elements BBa_K137088 optimized (TA) repeat constitutive promoter with 19 bp 37 between-10 and -35 elements BBa_K137089 optimized (TA) repeat constitutive promoter with 21 bp 39 between-10 and -35 elements BBa_K137090 optimized (A) repeat constitutive promoter with 17 bp between- 35 10 and -35 elements BBa_K137091 optimized (A) repeat constitutive promoter with 18 bp between- 36 10 and -35 elements BBa_K137124 LacI-repressed promoter A81 103 BBa_K143010 Promoter ctc for B. subtilis 56 BBa_K143011 Promoter gsiB for B. subtilis 38 BBa_K143012 Promoter veg a constitutive promoter for B. subtilis 97 BBa_K143013 Promoter 43 a constitutive promoter for B. subtilis 56 BBa_K143014 Promoter Xyl for B. subtilis 82 BBa_K143015 Promoter hyper-spank for B. subtilis 101 BBa_K145152 Hybrid promoter: P22 c2, LacI NOR gate 142 BBa_K157042 Eukaryotic CMV promoter 654 BBa_K165000 MET 25 Promoter 387 BBa_K165015 pADH1 yeast constituative promoter 1445 BBa_K165017 LexA binding sites 393 BBa_K165037 TEF2 yeast constitutive promoter 403 BBa_M13101 M13K07 gene I promoter 47 BBa_M13102 M13K07 gene II promoter 48 BBa_M13103 M13K07 gene III promoter 48 BBa_M13104 M13K07 gene IV promoter 49 BBa_M13105 M13K07 gene V promoter 50 BBa_M13106 M13K07 gene VI promoter 49 BBa_M13108 M13K07 gene VIII promoter 47 BBa_M13110 M13110 48 BBa_M31201 Yeast CLB1 promoter region, G2/M cell cycle specific 500 BBa_M31232 Redesigned M13K07 Gene III Upstream 79 BBa_M31252 Redesigned M13K07 Gene V Upstream 72 BBa_M31272 Redesigned M13K07 Gene VII Upstream 50 BBa_M31282 Redesigned M13K07 Gene VIII Upstream 146 BBa_M31292 Redesigned M13K07 Gene IX Upstream 69 BBa_M31302 Redesigned M13K07 Gene X Upstream 115 BBa_M31370 tacI Promoter 68 BBa_M31519 Modified promoter sequence of g3. 60 BBa_R0001 HMG-CoA Dependent RBS Blocking Segment 53 BBa_R00100 Tet promoter and sRBS 67 BBa_R00101 VM1.0 to RiPS converter 36 BBa_R0085 T7 Consensus Promoter Sequence 23 BBa_R0180 T7 RNAP promoter 23 BBa_R0181 T7 RNAP promoter 23 BBa_R0182 T7 RNAP promoter 23 BBa_R0183 T7 RNAP promoter 23 BBa_R0184 T7 promoter (lacI repressible) 44 BBa_R0185 T7 promoter (lacI repressible) 44 BBa_R0186 T7 promoter (lacI repressible) 44 BBa_R0187 T7 promoter (lacI repressible) 44 BBa_R1028 Randy Rettberg Standardillator BBa_R1074 Constitutive Promoter I 49 BBa_R1075 Constitutive Promoter II 49 BBa_R2108 Promoter with operator site for C2003 72 BBa_R2110 Promoter with operator site for C2003 72 BBa_R2111 Promoter with operator site for C2003 72 BBa_R2112 Promoter with operator site for C2003 72 BBa_R2113 Promoter with operator site for C2003 72 BBa_R2182 RiPS generator 44 BBa_R2201 C2006-repressible promoter 45 BBa_R6182 RiPS generator 36 BBa_S03331 --Specify Parts List-- 30 BBa_S03385 Cold-sensing promoter (hybB) BBa_Z0251 T7 strong promoter 35 BBa_Z0252 T7 weak binding and processivity 35 BBa_Z0253 T7 weak binding promoter 35 BBa_Z0294 A1, A2, A3, boxA 435

REFERENCES

The references cited herein and throughout the application are incorporated herein by reference in their entirety.

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1. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene.
 2. The bacteriophage of any of claim 1, wherein the antibiotic resistance gene is selected from the group comprising cat, vanA or mecD or variants thereof.
 3. The bacteriophage of any of claim 1 or 2, wherein the cell survival gene is selected from the group comprising RecA, RecB, RecC, spot, RelA or variants thereof.
 4. The bacteriophage of any of claims 1 to 3, wherein the agent is selected from a group comprising, siRNA, antisense nucleic acid, asRNA, RNAi, miRNA and variants thereof.
 5. The bacteriophage of any of claims 1 to 4, wherein the agent is an antisense RNA (asRNA).
 6. The bacteriophage of any of claims 1 to 5, wherein the bacteriophage comprises a nucleic acid encoding at least two agents that inhibit at least two different cell survival repair genes.
 7. The bacteriophage of any of claims 1 to 6, wherein the bacteriophage comprises a nucleic acid encoding at least two agents that inhibit at least two of RecA, RecB or RecC.
 8. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene and/or bacterial defense gene.
 9. The bacteriophage of any of claims 8, wherein the repressor of a SOS response gene is lexA.
 10. The bacteriophage of any of claim 8 or 9, wherein the repressor of a defense gene is SoxR.
 11. The bacteriophage of any of claims 8 to 10, wherein the repressor is selected from the group consisting of; marR, arcR, fur, crp, icdA or variants or fragments thereof.
 12. The bacteriophage any of claims 8 to 11, wherein the bacteriophage comprises a nucleic acid encoding at least two different repressors of at least one SOS response gene.
 13. The bacteriophage any of claims 8 to 12, wherein the bacteriophage comprises a nucleic acid encoding at least two different repressors of at least one bacterial defense gene.
 14. An engineered bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent which increases the susceptibility of a bacteria cell to an antimicrobial agent.
 15. The bacteriophage of claim 14, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent increases the efficacy of the antimicrobial effect of the antimicrobial agent by at least 10%.
 16. The bacteriophage any of claim 14 or 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent increases the entry of an antimicrobial agent to a bacterial cell.
 17. The bacteriophage of any of claims 14 to 16, wherein the agent which increases the entry of an antimicrobial agent to a bacterial cell is a porin.
 18. The bacteriophage of any of claims 14 to 17, wherein the porin is ompF or variants or fragments thereof.
 19. The bacteriophage of any of claims 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent is craA or variants or fragments thereof.
 20. The bacteriophage of any of claims 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent is craA or variants or fragments thereof.
 21. The bacteriophage of any of claims 14 to 15, wherein the agent which increases the susceptibility of a bacteria cell to an antimicrobial agent modifies a pathway specifically expressed in a bacterial cell.
 22. The bacteriophage of any of claim 14 to 15 or 21, wherein modification is inhibition or activation of a pathway specifically expressed in a bacterial cell.
 23. The bacteriophage of any of claims 14 to 15, wherein the agent which increases iron-sulfur clusters in the bacterial cell.
 24. The bacteriophage of any of claims 14 to 15, wherein the agent which increases oxidative stress in a bacterial cell or increases hydroxyl radicals in a bacterial cell.
 25. The bacteriophage of any of claims 14 to 24, wherein the agent is not substantially toxic a bacterial cell in the absence of an antimicrobial agent.
 26. The bacteriophage of any of claims 14 to 25, wherein the agent is not a chemotherapeutic agent or an protein toxin.
 27. The bacteriophage of any of claims 14 to 26, wherein the bacteriophage comprises a nucleic acid encoding at least two different proteins which increase the susceptibility of a bacteria cell to an antimicrobial agent.
 28. The bacteriophage of any of claims 14 to 27, wherein the proteins are csrA and ompF or variants or fragments thereof.
 29. The bacteriophage of any of claims 1 to 28, wherein the bacteriophage is a lysogenic bacteriophage.
 30. The bacteriophage of any of claims 1 to 29, wherein the lysogenic bacteriophage is a M13 bacteriophage.
 31. The bacteriophage of any of claims 1 to 29, wherein the bacteriophage is a lytic bacteriophage.
 32. The bacteriophage of any of claim 1 to 29, or 31 wherein the lytic bacteriophage is a T7 bacteriophage.
 33. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene, and (b) at least one antimicrobial agent.
 34. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising a nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene or a bacterial-defense gene, and (b) at least one antimicrobial agent.
 35. A method to inhibit or eliminate a bacterial infection comprising administering to a surface infected with bacteria; (a) a bacteriophage comprising nucleic acid operatively linked to a bacteriophage promoter, wherein the nucleic acid a encodes at least one agent which increases the susceptibility of a bacteria cell to an antimicrobial agent, and (b) at least one antimicrobial agent.
 36. The method of claim 33, wherein the bacteriophage is a bacteriophage according to any of claim 1 to 7 or 29-32.
 37. The method of claim 34, wherein the bacteriophage is a bacteriophage according to any of claim 8 to 13 or 29-32.
 38. The method of claim 35, wherein the bacteriophage is a bacteriophage according to any of claims 14 to
 32. 39. The method of any of claims 33 to 38, wherein the administration of the bacteriophage and the antimicrobial agent occurs simultaneously.
 40. The method of any of claims 33 to 38, wherein the administration of the bacteriophage occurs prior to the administration of the antimicrobial agent.
 41. The method of any of claims 33 to 38, wherein the administration of the antimicrobial agent occurs prior to the administration of the bacteriophage.
 42. The method of any of claims of any of claims 33 to 38, wherein the antimicrobial agent is a quinolone antimicrobial agent.
 43. The method of claims 33 to 42, wherein the antimicrobial agent is selected from a group consisting of ciproflaxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin or variants or analogues thereof.
 44. The method of any of claims 33 to 38, wherein the antimicrobial agent is ofloxacin or variants or analogues thereof.
 45. The method of any of claims 33 to 38, wherein the antimicrobial agent is an aminoglycoside antimicrobial agent.
 46. The method of claim 45, wherein the antimicrobial agent is selected from a group consisting of amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin or variants or analogues thereof.
 47. The method of any of claims 33 to 38, wherein the antimicrobial agent is gentamicin or variants or analogues thereof.
 48. The method of any of claims 33 to 38, wherein the antimicrobial agent is an β-lactam antibiotic antimicrobial agent.
 49. The method of any of claims 33 to 38, wherein the antimicrobial agent is selected from a group consisting of penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof.
 50. The method of any of claims 33 to 38, wherein the antimicrobial agent is ampicillin or variants or analogues thereof.
 51. The method of any of claims 33 to 38, wherein the bacteria is present in a subject.
 52. The method of any of claims 33 to 51, wherein the subject is a mammal.
 53. The method of any of claims 33 to 52, wherein the mammal is a human.
 54. The method of any of claims 33 to 53, wherein the bacteria is in a biofilm.
 55. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene and at least one antimicrobial agent.
 56. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response gene or a antimicrobial defense gene and at least one antimicrobial agent.
 57. A composition comprising a bacteriophage comprising a nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one protein which increases the susceptibility of a bacteria cell to an antimicrobial agent and at least one antimicrobial agent.
 58. The composition of any of claims 55 to 57, wherein the antimicrobial agent is a quinolone antimicrobial agent, or aminoglycoside antimicrobial agent or β-lactam antimicrobial agent.
 59. The composition of any of claim 55 or 58, wherein the bacteriophage is according to any claim 1-7 or 29-32.
 60. The composition of claim 56 or 58, wherein the bacteriophage is according to any claim 8 to 13 or 29-32.
 61. The composition of claim 57 or 58, wherein the bacteriophage is according to any claims 14 to
 32. 62. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one agent that inhibits an antibiotic resistance gene and/or a cell survival repair gene.
 63. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one repressor of a SOS response or an antimicrobial defense gene.
 64. A kit comprising a bacteriophage comprising the nucleic acid operatively linked to a promoter, wherein the nucleic acid encodes at least one protein which increases the susceptibility of a bacteria cell to an antimicrobial agent and at least one antimicrobial agent.
 65. The use of a bacteriophage according to any of claims 1 to 23 in combination with an antimicrobial agent to reduce the number of bacteria as compared to use of the antimicrobial agent alone.
 66. The use of any of the claims 62-65, wherein the bacteria is in a biofilm.
 67. A combination of at least two bacteriophages of any of claims 1 to 23 with at least one antimicrobial agent.
 68. The combination of claim 67, wherein the antimicrobial agent is a quinolone antimicrobial agent.
 69. The combination of claim 67, wherein the antimicrobial agent is selected from a group consisting of ciproflaxacin, levofloxacin, and ofloxacin, gatifloxacin, norfloxacin, lomefloxacin, trovafloxacin, moxifloxacin, sparfloxacin, gemifloxacin, pazufloxacin or variants or analogues thereof.
 70. The combination of claim 67, wherein the antimicrobial agent is ofloxacin or variants or analogues thereof.
 71. The combination of claim 67, wherein the antimicrobial agent is an aminoglycoside antimicrobial agent.
 72. The combination of claim 67, wherein the antimicrobial agent is selected from a group consisting of amikacin, gentamycin, tobramycin, netromycin, streptomycin, kanamycin, paromomycin, neomycin or variants or analogues thereof.
 73. The combination of claim 67, wherein the antimicrobial agent is gentamicin or variants or analogues thereof.
 74. The combination of claim 67, wherein the antimicrobial agent is an β-lactam antibiotic antimicrobial agent.
 75. The combination of claim 67, wherein the antimicrobial agent is selected from a group consisting of penicillin, ampicillin, penicillin derivatives, cephalosporins, monobactams, carbapenems, β-lactamase inhibitors or variants or analogues thereof.
 76. The combination of claim 67, wherein the antimicrobial agent is ampicillin or variants or analogues thereof.
 77. The combination of claim 67, wherein the composition comprises a combination of any of the antimicrobial agents according to claims 68-76.
 78. Use of a bacteriophage of any of claims 1 to 32 with at least one antimicrobial agent.
 79. Use of a combination of at least two of any the bacteriophages of claims 1 to 32 with at least one antimicrobial agent.
 80. The use of a bacteriophage of claim 78 or 79 or any to claims 1 to 32 to inhibit or eliminate a bacterial infection.
 81. The use of a bacteriophage of claim 78 or 79, wherein the bacteria is present in a subject.
 82. The use of a bacteriophage of claim 81, wherein the subject is a mammal.
 83. The use of a bacteriophage of claim 82, wherein the mammal is a human.
 84. The use of a bacteriophage of claim 78 or 79, wherein the bacteria is in a biofilm.
 85. Use of a composition of any of claims 55 to 57 to inhibit or eliminate a bacterial infection.
 86. The use of the composition of claim 85, wherein the bacteria is present in a subject.
 87. The use of the composition of claim 86, wherein the subject is a mammal.
 88. The use of the composition of claim 87, wherein the mammal is a human.
 89. The use of the composition of claim 85, wherein the bacteria is in a biofilm. 